Background to this inspection
Updated
28 September 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 26 June 2015 and 28 July 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service we needed to be sure that someone would be in. There are gaps between the two visit dates because after our visit to the office we had to make phone calls to staff and to people who used the service. We then had to review all of this information. This review identified that we needed to gather more information to rate the service. Therefore a second visit was arranged. The inspection team consisted of two inspectors.
As part of the inspection, we spoke with nine people and six relatives. We also spoke with four care staff, the registered manger, the operations manager and the care co-ordinator.
Updated
28 September 2015
The inspection took place on 26 June 2015 and 28 July 2015 and was announced.
The service provides personal care to people living in the community. At the time of the inspection, approximately 77 people used the service and a registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People told us that they felt that felt safe and staff understood how to keep them safe. However, staff shortages put pressure on care staff and care calls were often later than agreed and could be up to two hours late. Although no one was harmed, people’s safety was compromised.
People were happy with the support they received and people who required additional medication were also supported to receive this.
People received care from care staff that were not always confident in how to move people. Staff did not always raise issues stating they lacked confidence to discuss and share their training needs. Whilst people did not experience adverse harm, the registered manager agreed there had been an issue and was already putting in steps to resolve the problem.
People’s consent was appropriately obtained by staff when caring for them and people who could not make decisions for themselves were supported by representatives, such as a person with a Power of Attorney that the staff were aware of.
People enjoyed the meals prepared for them and were supported to eat and drink enough to keep them healthy. Care staff involved people in deciding what meals and snacks they would like. Where people had special dietary requirements, care staff understood these and took their needs into account.
People’s care needs were regularly reviewed and updated. Changes in people’s care needs were shared with care staff so they respond to people’s needs accordingly. Where care staff became concerned or unsure, they would either contact the registered manager, a relative or the GP.
People liked the staff that cared for them and care staff involved people when caring for them. People’s privacy and dignity were respected and people were treated in a manner they would expect to be treated in and were supported to make choices affecting their care.
People were aware of how to raise complaints and some people had complained. However, people did not always feel they received an adequate response to their complaint. Although the complaints received were responded to, patterns and trends in people’s complaints had not caused the management to identify people’s growing dissatisfaction with the service.
Although people’s care was monitored the quality of their care was not. The quality of the care people received was not effectively checked and reviewed to ensure improvements were made where necessary.