Background to this inspection
Updated
31 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector and an Expert by Experience (ExE). An ExE is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with the registered manager. We also spoke with the assistant manager, one care staff and an administrator. We looked at four people’s care records and associated medicine records. We looked at records of accidents, incidents, compliments and complaints received by the service.
We looked at audits and quality assurance reports completed, safeguarding concerns, recruitment records, staff supervision, appraisal records and team meeting minutes.
After the inspection
We asked or requested additional information. This included County Care policies and procedures, staff training records and feedback from seven care staff and 15 relatives. We requested feedback from seven professionals but did not receive a response.
Updated
31 August 2019
About the service
County Care (Windsor) a is a Domiciliary Care Agency (DCA) providing personal care to children and adults. Staff provided care to people within their own homes. At the time of inspection, the service was supporting 34 adults.
Not everyone who used the service received personal care. CQC only inspects where adults receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Required staff recruitment checks including criminal checks with the Disclosure and Barring Service were carried. However, the management team could not always evidence they had taken a full employment history of some staff. We made a recommendation that the provider refers to current guidance to operate robust recruitment procedures, including undertaking any appropriate relevant checks.
People’s care plans identified how their medical condition impacts on their lives and the required action to take to minimise pain. Mental health assessments were in place to detail the outcomes people wanted to achieve. The provider had an effective system to ensure that staff received appropriate training, and all mandatory training was up to date.
However, the recording of certain actions taken to keep people safe needed to be further strengthened. We made a recommendation to the provider to consider current guidance on maintaining securely an accurate, complete and contemporaneous records.
There were effective systems in place to safeguard people from harm and abuse. Where a safeguarding concern had been raised, in relation to young people or adults, the registered manager dealt with them appropriately and communicated with all necessary agencies. Risk assessments and care support plans were comprehensive and were reviewed when required to ensure they were kept up to date and reflected any changing needs. People’s medicines were managed safely, and new audits system had been put in place to highlight any shortfalls.
People experienced positive relationships with staff who treated them with kindness in their day-to-day care. Staff consistently treated people with dignity and respect and maintained their privacy. Staff had a detailed understanding of people’s needs. The service promoted and delivered person-centred care.
There was a clearly defined management structure within the service and quality of the service was monitored through robust clinical governance processes. Staff understood people's needs and preferences and recognised the importance of knowing people well. Staff told us they felt supported by management. Complaints were dealt with effectively. Relative’s stated all concerns were dealt with in a timely manner.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.CQC.org.uk
Rating at last inspection
The last rating for this service was good (report published 24 January 2017) 15 December 2016.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.