Background to this inspection
Updated
20 February 2019
The inspection
‘We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.’
Inspection team
One inspector and an Expert by Experience conducted the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience undertook telephone calls to five people and relatives of five people who were unable to speak with us directly.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides a service to younger and older adults.
The service had a registered manager who registered with the Care Quality Commission. This means 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
This inspection was announced. We gave the service 48 hours’ notice of the inspection site visit to ensure the registered manager would be present and to ensure people’s consent was gained for us to contact them for their feedback. We visited the office location on 20 December 2018 and 14 January 2019 to see the registered manager and to review care records, policies and procedures. We made calls to people who used the service on 12 December 2018, and to the staff on 10 January 2019.
What we did
Before the inspection we reviewed the information we held about the service and the service provider. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
During the inspection, we spoke with five people using the service and five relatives to ask about their experience of care. We spoke with the registered manager and four members of staff. We looked at the care and medicines records for three people, staff employment related records and records relating to the quality and management of the service. Details are in the Key Questions below.
Updated
20 February 2019
About the service: This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides a service to younger and older adults.
People’s experience of using this service:
• People’s visits were not planned to ensure people were safe and staff were rostered to complete one visit before commencing a second.
• Staff were not enabled to complete visits and have time to travel to their next care visit.
• People’s visits were not planned to ensure they received regular visits from staff who knew their care preferences.
• Staff were trained to administer medicines; however, people were not always assisted to have their medicines at the prescribed time.
• People received care and support based on their individual assessed needs and preferences.
• People had a care plan which detailed the risks involved in people’s personal care.
• People were supported by staff to maintain plenty of fluids, however, some staff struggled to produce some meals for people. The provider ensured that staff received training based on people’s individual needs. Staff worked well to ensure people were supported to access health services and people were involved and encouraged to make decisions about the care offered.
• People were treated with kindness and were positive about the staff’s caring attitude. People were encouraged to express their views and make decisions about the care they received. People told us they felt staff treated them with respect and dignity and encouraged them to maintain their independence for as long as possible.
• Staff did not always understand the needs of people, and some staff were unable to communicate efficiently.
• We found some of the provider's quality assurance systems needed improvement as they did not identify all the shortfalls in records. The registered manager understood their legal responsibility for notifying the Care Quality Commission of incidents that involved the people who received a care service. Some people and people’s relatives had been given the opportunity to comment on the service by a written questionnaire and telephone surveys.
Rating at last inspection: The agency was rated as Good at the last inspection in October 2016.
Why we inspected: We brought forward this inspection from the normal schedule, due to concerning information from the local authority.
Enforcement: Action provider needs to take is included at the end of this report.
Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated ‘Requires Improvement.’