30 April 2018
During a routine inspection
The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the Leeds, Castleford and Wakefield areas. At the time of our inspection 107 people were using the service.
The service had 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. The registered manager was also the nominated individual for the provider and a company director.
The provider had policies and procedures in place to guide staff in safeguarding vulnerable adults from abuse. Staff we spoke with understood the different types of abuse and were able to explain what they would do if they had any concerns.
We found that people’s needs were assessed and risk assessments were in place to reduce risks and prevent avoidable harm.
The provider had a robust system for the recruitment of staff. The provider had a system in place to ensure that care visits were scheduled in line with people’s requirements but we received mixed feedback about whether staff always arrived on time. Nobody we spoke with told us that any of their care visits had been missed.
Where staff supported people with their medicines, we found that this was recorded on medication administration records. Staff had received medication training and the provider completed audits of medication records to identify any gaps and anomalies. This enabled the provider to check that people were getting their medicines as prescribed.
Staff completed a range of appropriate training to help them carry out their roles effectively and there was a schedule for refreshing this training when it was required. Staff received regular supervision and appraisal.
The provider sought consent to provide care in line with legislation and guidance. There was information in care files about people’s mental capacity to make particular decisions and we found that care plans were signed by people who used the service where they had the capacity to do so. The provider did not always retain evidence where people had a lasting power of attorney with authority to make decisions in relation to their financial affairs or health and welfare. They agreed to do this moving forward.
People were supported to maintain good health and access healthcare services. We saw evidence in care files of contact with other healthcare services, such community nurses. People’s nutritional needs were assessed and support was provided with meal preparation and assisting people to eat and drink, where this was part of a person’s care plan.
People and relatives told us staff were caring. Some people spoke very affectionately about particular staff who cared for them regularly. People told us they were involved in decisions about their care and their choices were respected. Staff were able to explain how they provided support to maintain people’s privacy, dignity and independence.
Care plans contained information about people’s care needs, routines and preferences. There was also information about any needs relating to faith, culture, disability and communication. Care plans were updated at least annually or when people’s needs changed.
There was a complaints procedure in place. Records we viewed showed that complaints were investigated and responded to in line with the provider’s policy.
The provider had a quality assurance system in place, which included monitoring key performance information and care records, completing spot checks of care delivery and conducting satisfaction surveys. The provider worked in partnership with other organisations. There was a positive culture within the organisation and a focus on staff development and continual improvement.