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Inspection Summary


Overall summary & rating

Good

Updated 6 December 2016

The inspection took place on 18 and 19 October 2016 and was announced. This meant we gave the provider 48 hours’ notice of our intended visit to ensure someone would be available in the office to meet us.

We last inspected Care Direct Salford on 29 July 2014, at which time it was meeting all our regulatory standards.

Care Direct Salford is a domiciliary care provider based in the Eccles area of Manchester, providing personal care to people in their own homes in the local area. At the time of our inspection the service provided personal care to 60 people, the majority of whom required help to maintain their independence at home.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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 2008 and associated Regulations about how the service is run. The registered manager had extensive experience of working in the social care sector. They demonstrated a strong awareness of areas of best practice and a good knowledge of the individual needs of people who used the service.

There were effective pre-employment checks of staff in place to ensure the risk of unsuitable people working with vulnerable people was reduced. Lone worker policies and procedures were in place with all staff receiving a first aid kit.

People who used the service expressed confidence in the ability of staff to keep them safe. No concerns were raised from local authority commissioning professionals or other sources and all relatives and external healthcare professionals we spoke with expressed similar confidence of the ability of staff to care for people safely.

We saw risk assessments were in place to ensure people were protected against a range of risks. These were regularly reviewed and staff displayed a good knowledge of the risks people faced. One risk assessment required improvement and the registered manager rectified this during the inspection. Staff had received safeguarding training and were confident in this area.

Medicines administration was regularly audited and we found no evidence of medication errors.

There were sufficient staff to meet people’s needs safely, with travel time included in the planning of care calls and spot checks undertaken to ensure staff arrived and left at the agreed times.

Staff were trained in core areas such as first aid, person-centred care, moving and handling, safeguarding and dementia and training needs were well monitored and refreshed.

We found staff had a good knowledge of people’s likes, dislikes, preferences, mobility and communicative needs.

People who used the service were supported to maintain their independence in their own homes, in line with the service user guide.

We found care plans generally to be sufficiently detailed and person-centred so as to give members of staff relevant information when providing care to people who used the service. Some care plans contained more background information about people who used the service and the registered manager agreed to review these sections of care plans to ensure new staff would have a better understanding of each person’s background.

Care plans were reviewed regularly and with the involvement of people who used the service and their relatives.

The registered manager displayed a good understanding of capacity and the need for consent on a decision-specific basis.

People’s changing needs were monitored, identified and met through liaison with a range of external health and social care professionals.

People we spoke with and relatives told us they had received positive outcomes when suggesting changes or raising queries. People told us they knew who to contact if they had concerns. Whilst the service user guide contained contact information, it did not make it explicitly clear how people could make a complaint and this needed to be rectified.

Staff, people who used the service, relatives and other professionals were generally in agreement that the registered manager led the service well and was accountable and approachable. We found them to have a good knowledge of the needs of people who used the service, and how the service could make improvements in the future.

We saw there were a range of audits and other quality checks to identify errors, inconsistencies, or scope for improvement.

The registered manager and staff had successfully established a caring culture and a service that met people’s needs, particularly with regard to provide a stable continuity of care from staff who people had grown to know and trust.

Inspection areas

Safe

Good

Updated 6 December 2016

The service was safe.

Risk assessments were in place and staff were able to explain how they protected people from the specific risks they faced, such as falling.

A range of pre-employment checks of staff ensured the risk of unsuitable people working with vulnerable adults was reduced.

Accidents and incidents were appropriately recorded to identify whether there were ongoing patterns or trends.

Effective

Good

Updated 6 December 2016

The service was effective.

Staff received a range of initial and ongoing training as well as support to attain health and social care qualifications.

Care visits were well planned, factoring in travel time. This minimised late visits, as confirmed by people who used the service.

People’s healthcare needs were met through the involvement of external healthcare professionals.

Caring

Good

Updated 6 December 2016

The service was caring.

People were treated with patience, dignity and respect by staff who knew them well, in line with the standards set out in the service user guide.

The service successfully delivered a continuity of care, with people consistently telling us they usually received the same carer, with whom they got on with well.

People were involved in the planning and review of their own care and the registered manager planned to involve people more in the recruitment process.

Responsive

Good

Updated 6 December 2016

The service was responsive.

Care plans were reviewed after an initial period and regularly after that, as well as being subject to change if the need arose.

Staff identified people’s changing needs and sought advice from external care professionals when this happened, incorporating this advice into care planning.

People who used the service and others knew how to raise concerns if they needed, although the service user guide required improvement to make the complaints procedure explicitly clear.

Well-led

Good

Updated 6 December 2016

The service was well-led.

People and relatives we spoke with were generally positive about the accountability and approachability of the registered manager.

Regular auditing was in place to scrutinise standards and to ensure errors were identified and rectified.

The registered manager displayed a comprehensive awareness of good practice in adult social care and had ensured the service had a caring, person-centred culture.