Background to this inspection
Updated
17 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
This inspection was announced and took place on 13, 14 and 15 December 2017 and 10 January 2018.
We gave the service 48 hours’ notice of the inspection visit because it is office based and the manager is often out supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started on 13 December 2017 and ended on 15 December 2017. It included talking with staff, looking at records, speaking with the management and visiting people in their homes. We visited the office location on 13 and 15 December 2017 to see the manager and office staff; and to review care records and policies and procedures. During the inspection phone calls were made to people who use the service and their relatives on 14 December 2017. Further phone calls were made to staff on 10 January 2018.
The inspection was carried out by three adult social care inspectors and two expert by experiences. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to this inspection the provider completed a Provider Information Return (PIR). We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the home before the inspection visit.
We spoke with four people, two relatives and one health care professional during the visits to people’s home. We spoke with 13 people and six relatives on the telephone. We spoke with the operations manager, a registered manager from another service, the manager and eight care staff. Following the inspection on site, we spoke with another three staff members on the telephone.
We looked at 10 people’s care records and observed care and support when in people’s homes. We looked at seven staff files, staff rotas, quality assurance audits, staff training records, the complaints and complements, staff meeting minutes, newsletters, medication files, statement of purpose, provider internal communication documents, and a selection of the provider’s policies.
Following the inspection the manager sent us an action plan of improvements they were making since the inspection.
Updated
17 April 2018
This inspection was announced and took place on 13, 14 and 15 December 2017 and 10 January 2018.
This service is a domiciliary care agency. It provides personal care including nursing to 177 people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children.
Not everyone using Somerset Care Community (South Somerset) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At the time of the inspection there was a manager in post applying to be the 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. They were supported by a care manager to run the service and the operations manager. On the first day of inspection a registered manager from another of the provider’s services came to support the manager.
Some people with specific health conditions did not have enough guidance for staff to follow to ensure their needs were met consistently. People’s medicine was usually administered safely and in line with their needs. Improvements were required with the medicine administration records. Most accidents and incidents had lessons learnt identified and action taken. Sometimes these actions had not been recorded fully.
Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People were protected from potential abuse because staff were able to recognise signs and knew how to report it. People had a mixed opinion about whether there were enough staff; the management were taking actions to improve this. Some people did not feel their call times considered their medication needs which the management were going to review.
The provider and manager wanted to provide high quality care for people. People had mixed opinions about the management because they felt changes had not been communicated to them. There was a positive approach to improving the service. Staff felt supported and the new manager and provider had brought about positive improvements. The management had systems to monitor the quality of the service and made improvements in accordance with people’s changing needs. They had completed statutory notifications in line with legislation to inform external agencies of significant events.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. When people lacked capacity actions to ensure the statutory principles of the Mental Capacity Act 2005 had not always been recorded. People and their relatives were positive about the food and meals were prepared to meet people’s needs and wishes.
Staff had the skills and knowledge required to effectively support people. People and their relatives told us their healthcare needs were met and staff supported them to see other health and social care professionals. Staff were proactive in identifying when people’s health started to decline.
People and their relatives told us, and we observed that staff were kind and patient. People’s privacy and dignity was respected by staff and their religious needs were valued. When people had specific needs or differences they had been considered by staff. People, or their representatives, were involved in decisions about the care and support they received.
Most care and support was personalised to each person which ensured they were able to make choices about their care. People and their relatives knew how to complain. There was a complaints policy and complaints had been managed. There were occasions the outcomes had not been communicated with the relevant people.