8 May 2014
During a routine inspection
If you want to see the evidence supporting our summary please read the full report.
We considered our inspection findings to answer five questions we always ask;
' Is the service safe?
' Is the service caring?
' Is the service responsive?
' Is the service effective?
' Is the service well led?
Is the service safe?
People using the service told us they felt safe.
We saw the agency's safeguarding procedures were robust and found that managers and staff understood how to protect the vulnerable people they supported. Appropriate disciplinary action was taken by the agency against staff when necessary.
We saw staff regularly assessed potential risks to people's health and welfare. Staff had access to appropriate guidance about how to manage identified risks and keep people safe.
Since the last inspection the registered manager had improved staff recruitment practices. This meant people were protected from being supported by staff that were not fit to work with vulnerable people.
People were cared for by staff who were able to deliver care safely and to an appropriate standard because they had been suitably trained to meet people's needs and were well supported by the agency's managers and senior staff team.
Managers and staff learnt lessons from events that adversely affected the people using the service such as accidents, incidents, mistakes, near misses, complaints, concerns, staff whistleblowing and safeguarding investigations. This meant risks to people who used the service was reduced and also helped the agency to continually improve its practices.
The agency had a twenty-four hour on call service for dealing with emergencies and issues such as staff absence or sickness.
Is the service caring?
People we spoke with told us they were happy with the care and support provided by the agency. One person said 'I would give them ten out of ten' and another person told us 'I am very happy with the agency'They are excellent.'
People were supported by kind and attentive staff. People told us staff who worked for the agency were compassionate and caring, and most said care workers usually turned up when they were meant to and stayed for the agreed length of time. Typical comments we received included, 'The staff are brilliant'They treat me so well.', 'My carers often go above and beyond their duties.' and 'Once in a while carers are late, but the agency always calls to let us know.'
People's needs were thoroughly risk assessed by staff and peoples wishes and needs recorded in their personalised care plan before they received any domiciliary care services from the agency.
The agency respected people's diversity by ensuring that where possible they tried to match people who used the service with staff who understood their first language and/or cultural needs and preferences.
Is the service responsive?
People knew how to make a complaint if they were unhappy with the service they received. Three people said that they had made a formal complaint about the agency in the last twelve months, but were satisfied with the way their concerns had been dealt with. One person told us they were happy with the way the agency had dealt with the issues they had raised about their relatives care. We looked at how these complaints had been handled by the agency, and found that the responses had been open, thorough and timely. This meant that people can be assured that complaints are investigated and appropriate action taken as necessary to address these shortfalls.
The provider had effective systems in place to routinely obtain the views of people using the service and their relatives through care plan review meetings, fortnightly telephone contact and the use of satisfaction surveys. People's views were taken into account by the agency and appropriate changes made. This meant people using the service were involved in assessing the service they received and helping the agency to make improvements.
Is the service effective?
People's care and support needs were assessed with them, and they were involved in helping staff write their care plan. We saw care plans provided care workers with enough detailed guidance about how they should be supporting people to meet their personal care needs. Staff demonstrated they understood the care needs of the pole they supoprted, and were familiar with these individuals wishes and daily routines. Care plans and risk assessments were continually reviewed by staff and updated accordingly to reflect any changes in people's needs.
The agency had a matching process that ensured care coordinators took account of people's care needs when making decisions about the numbers, skills and experience of the care staff required to support them.
Is the service well-led?
The registered provider/manager has been in day-to-day charge of the agency for many years, is very experienced and was able to demonstrate that they had the knowledge and skills to manage the service well. People using the service and their relatives told us they felt the leadership of the service was excellent and staff we spoke with said Day and Nite domiciliary care agency was a good place to work.
The provider had effective systems in place to regularly assess and monitor the quality of service that people received. For example, senior staff carried out weekly spot checks on staff during home visits to ensure they turned up on time, wore their uniforms and identification badges, and completed the tasks as stated in people's care plans. The agency is also regularly audited by an external clinical governance consultant. These audits are routinely analysed and where issues are found, an action plan is put in place that states what the service needs to do to improve its performance. Staff are also encouraged to provide feedback to their managers, so their knowledge and experience can be taken into account and used to improve the agency.