7 October 2016
During a routine inspection
The service has a registered manager. 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 2008 and associated Regulations about how the service is run.
This announced inspection took place on 7 and 10 October 2016 and included visits to the office, staff interviews and visits to people in their own homes. At the time of this inspection 28 people were using the service, all of whom were receiving support with their personal care needs.
Although this service has been established for a number of years, this was the first inspection of the service since it registered with us at its current location.
People, their relatives and staff told us the service was managed well. One person said “It’s an excellent organisation” and another said, “I must say they are brilliant.” People said they felt safe with the staff when receiving care. They said they had a regular staff team whom they had come to trust and know well. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy and said any issues would be dealt with thoroughly. One member of staff said, “If I wasn’t happy about anything I would talk to [name of registered manager] and she would deal with it.”
Risks to people’s health and safety had been assessed and were regularly reviewed. Assessments related to people’s health care and mobility needs, as well as environmental considerations, such as stairs or the safety of kitchen equipment. Staff were given information about how to minimise the chance of harm occurring to people and themselves. Should an accident occur in a person’s home, the circumstances of the accident were reviewed to identify any actions to reduce the likelihood of a reoccurrence. The service supported some people to take their medicines. Care plans provided information about each person’s medicines and when these should be taken. People told us the staff supported them safely and they received their medicines as prescribed.
The service employed sufficient numbers of safely recruited and well trained staff to meet people’s needs. Staff told us they had the training they needed to carry put their role, including moving and transferring people safely, infection control, first aid, pressure area care and caring for people living with dementia. Staff told us they enjoyed their job and felt supported and valued by the registered provider and registered manager.
People told us they had never had a missed call, and if the staff were going to be late they always received a phone call to notify them. Staff told us they had no concerns over the planning of visits and they were provided with sufficient paid travel time. They said they had enough time to ensure they delivered care safely and visits were not compromised by having to leave early to get to their next person on time.
People and their relatives were very positive about the way staff supported them. Each person we spoke with told us their care staff were kind and compassionate. One person said, “They are very helpful, caring and cooperative” and another said, “The girls are very kind.” Staff performance was regularly reviewed through observation, spot checks and supervisions to ensure they were meeting people’s needs respectfully and in the manner people preferred.
The service used a care assessment document to identify the care tasks people required assistance with, such as with washing and dressing, and this document was used as the person’s care plan. We found some care plans provided more detail than others about what people could do for themselves and their preferences in how they wished to be cared for. For example, one person’s care plan instructed staff to assist the person to wash and dress, while another gave staff step by step guidance about how to do this in the way the person preferred. The registered manager said they would review each plan to ensure they held detailed guidance and instructions for staff about people’s’ specific care needs and preferences.
Staff knew people well and were able to tell us how they supported them. The service was flexible and responsive to changes in people’s needs. For example, one person told us they had earlier visits before their hospital appointments. The service was also able to respond to requests from the local authority to provide immediate and urgent care to people.
Some of the people receiving a service were living with dementia which affected their ability to make decisions about their care and support. The registered manager and the staff had a good awareness of the Mental Capacity Act 2005. Staff said they asked people every day about whether they were happy to receive care and to allow them to make what decisions they could.
People and their relatives had no concerns over the care and support they received and they felt able to make a complaint if something was not right. One person told us, “I’ve got no complaints at all.” The service had received no complaints this year.
Staff meetings provided opportunities to review the development and continued improvement of the service. Staff told us the registered provider and the management team were very approachable, were keen to hear their views and were always available.
Audits were carried out monthly to monitor the quality of the service provided The service sought regular feedback from people who used the service and the results of the most recent surveys sent to people in March 2016 were very favourable. The registered manager told us they had signed up to the Social Care Commitment. This is a commitment from social care services to provide people with high quality care and support. They said they kept up to date with current issues in the care profession by accessing care related websites and attending external training events.