Archived: Kingstanding - Birmingham

As part of our inspection we visited the agency’s office to look at records and spoke with the registered manager and care co-ordinator. We looked at the care records of four people and five carers. We contacted eight people or their relatives on the telephone to get their views on the service they received and we spoke with three staff. We used this information to ask our five questions:

Is the service safe?

All the people we spoke with told us that they felt safe with the carers that supported them. One person told us, “I have the best carer in the world.” Another person told us, “X feels safe. The carer knows what X likes and doesn’t like.”

The provider had policies and procedures in place to protect people from harm. All the staff spoken with told us and records confirmed that they had received training on how to protect people from abuse. They were able to give examples of the actions they would take if they suspected any abuse.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes and hospitals. The service provided support to people in their own homes. No one living in their home had had their liberty restricted. One member of staff told us about how they managed people who did not have capacity to make decisions about whether to take their medicines. They told us about the actions they would take to support them whilst still giving them a choice. This showed that they understand about people’s capacity to make decisions and choices and their responsibilities to keep them safe.

We saw that recruitment records showed that the appropriate checks were undertaken to ensure that only appropriate staff were employed to work with vulnerable people.

Is the service caring?

All the people spoken with told us that the carers were good. One person told us, “I ask and they (staff) give the help I want.” Another person said, “They (staff) come four times a day, they’re very good. Come at the right time.”

We saw from records and staff and people confirmed that care staff made sure that professionals involved in people’s care were contacted if needed, for example, if people’s needs changed. People told us they felt safe with the staff. This showed that staff had made good relationships with people.

Is the service responsive?

We saw that questionnaires had been sent out to get the views of people who received a service and there was analysis of the findings to show where improvements could be made.

We saw that there was a system in place for recording and monitoring complaints however no complaints had been recorded. All the people we spoke with told us they knew who to contact if they were unhappy. They told us that there was always someone available on the telephone numbers they had. The care co-ordinator told us that concerns were addressed immediately but they were not always recorded. One person told us that there had been a problem but this had been resolved. This meant people were listened to and concerns addressed.

Most people spoken with told us that they were kept informed if staff were going to be late but two people felt they were not kept informed and sometimes there were different carers that turned up. This meant that efforts were made to keep people informed but some improvements could be made.

Is the care effective?

All the people spoken with told us that they had never had any calls where staff had not attended. Everyone was happy with the care provided and we saw that staff noted where changes had occurred in people’s needs and the appropriate professionals were contacted. Records showed and people confirmed that reviews were held and they were sometimes asked if they were happy with the care they received. This meant that the care provided met people’s needs and changing needs were identified and planned for.

We saw that care plans and risk assessments were in place. This meant that staff were able to provide safe and appropriate care to people so that their individual needs were met.

Some people told us and records showed that the service was not always effective in providing care and support to people at the agreed times and for the amount of time agreed. However, all the people we spoke with told us that they did not have any concerns about this and were happy with the care and support they received.

The call monitoring system in place did not always ensure that managers were made aware if calls had been missed or were likely to be missed. This meant that the systems in place were not always effective.

Is the service well led?

The registered manager was responsible for overseeing two locations. The registered manager confirmed that she was not able to give sufficient time to ensure the proper organisation of this location.

We saw that systems in place, for example spot check on staff practices, accidents and complaints were not monitored. This meant the analysis in these areas to identify trends was not always completed to identify improvements.

We saw that staff received training to ensure that they had the skills to provide safe care however there were few opportunities for staff to discuss practice issues and for the managers to ensure that staff understood the policies and procedures in place as supervision and staff meetings were not held regularly. This meant that the management of the location at Kingstanding could be improved. We have asked the provider to address this issue.

At the time of our inspection the service provided personal care and support to 53 people. We spoke with seven people who used the service and three of their relatives. The registered manager was not available on the day of our inspection however, we spoke with the care coordinator who was responsible for the day to day management of the service and also four members of staff. We also looked at four sets of care records for people who used the service.

Care was person centred and delivered in a way that people preferred. One person told us, “Staff ask me how I would like things done".

Recruitment processes were in place which gave people who used the service, some assurances that only suitable staff had been employed.

There was enough qualified, skilled and experienced staff to meet people's needs.

People were cared for by staff who were supported, supervised and trained to deliver care to an appropriate standard. One person told us, "The staff are very friendly and helpful".

The provider had a system in place to regularly assess and monitor the quality of service that people received.

A lack of detail, inconsistencies and gaps in record keeping meant that people were not protected from the risks of unsafe or inappropriate care.

All of the people using the service that we spoke with were generally happy with the standard of care that they were receiving. One person commented “The care is good". Another person that we spoke with told us “I have no complaints, I am very happy with everything ".

People told us that they were afforded dignity and respect and their independence was promoted.

Care plans and risk assessment were in place to support people’s needs. People had choices available to them and their care was person centred so that they received their care in the way that they preferred.

Safeguarding procedures were in place and staff were confident that they would recognise and report any allegations of abuse so that people were protected from the risk of harm.

Staff were supported, supervised and trained to provide safe and effective care.

Systems were in place for the ongoing monitoring of the quality of service provided to ensure that standards were maintained.