Ignite Health and Home Care Service

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were positive about the care they received and felt safe being supported by staff who they were familiar with. Staff understood how to keep people safe and the registered manager understood their obligations to notify relevant stakeholders of any concerns. People had up to date risk assessments in place to guide staff about the risks to people’s health. Recruitment processes included checks on potential staff to make sure they were suitable for the role. People were happy with the support they received with their medicines. Improvements had been made to the way in which people’s support was recorded and systems to review staff competency to support people had been updated.

People told us the service was well run and staff told us they were happy to work there. People gave feedback about their experiences of care and changes would be made where required. Staff understood the registered provider’s whistleblowing policy and felt able to raise concerns if required. The registered provider together with the registered manager understood their role and responsibilities and had systems in place to support this. The registered manager had taken on board feedback from the last inspection and had made improvements were required. Where appropriate District Nurses were referred to were appropriate to improve people’s experience of care.

The last rating for this service was requires Improvement (28 December 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ignite Health and Home Care Service on our website at www.cqc.org.uk.

Ignite Health and Home Care is a care at home service, providing personal to people aged 65 and over at the time of the inspection 19 people were using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 19 people who received personal care.

People’s experience of using this service and what we found

The provider did not always have safe processes and procedures in place for the management of medicines. People continued to tell us they felt safe and well supported. Staff had a good understanding in how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people had been identified, assessed and monitored. There were enough staff on duty to keep people safe and meet their needs. Safe practice was carried out to reduce the risk of infection.

The provider did not fully understand their registration requirements; the provider addressed this matter promptly. The checks the provider made ensured the service was meeting people’s needs and focused upon people’s views and experiences.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 06 June 2019)

Why we inspected

We received concerns in relation to the management of people’s call, staff training and staff recruitment checks. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has deteriorated to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ignite Health and Home Care Service on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

People who used the service and relatives told us they felt safe and staff treated them with respect. People were supported to remain safe in their own homes because staff were aware of the risks associated with people's needs and home environments and how to reduce these. Staff followed the provider’s safeguarding procedures and understood their responsibilities to keep people safe from abuse. People were supported with their medicines safely where this was required in accordance with their care plan.

People were supported by staff who had the necessary skills and knowledge to understand and meet people's needs. The provider followed appropriate recruitment procedures to assure themselves prospective staff were suitable to work with people who used the service. The provider had redesigned their induction arrangements for new staff to make sure care provided continued to be effective in meeting people’s needs. The management and senior staff team assessed staffing arrangements and made sure these met people’s individual needs. Staff felt supported in their caring roles.

People’s needs and choices were assessed before they received a care in their own homes to ensure these could be met effectively. Where required people were supported with eating and drinking in line with their care plans so they remained well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by kind and caring staff. People and their relatives were encouraged to be involved in making decisions about their care. People received care from staff who respected their privacy and dignity and promoted their independence.

People’s care plans had been improved to reflect people's likes and dislikes and personal preferences. People and/or their relatives had discussed their care needs with staff and were involved in the care planning process. Staff understood people’s preferences and individual communication needs. People’s end of life wishes were considered when needed and plans put in place to ensure people received personalised care at that time of their life.

People were aware of how they could raise a complaint or concern if they needed to and had access to the provider's complaint’s procedure.

The management, senior staff team and provider used systems to monitor the quality of the service, which included responding to feedback from people in relation to the standard of care provided in their own homes. The management team showed a responsive approach to making ongoing improvements following visits from local authority commissioners.

Rating at last inspection:

The rating at the last comprehensive inspection undertaken on 31 October 2017 was rated good. The report was published on 25 September 2018.

Why we inspected:

This was a planned inspection based on previous overall rating of good.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 31 October 2017 and was unannounced.

A registered manager was in post at the time of our inspection and was present for the inspection. The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with CQC 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.

At this inspection we found the provider was in breach of a regulation. This was because the provider had failed to display their current inspection ratings on their website. This is a legal requirement to show people had access to the ratings to inform their judgments about services.

People received the care and support they needed from staff to feel and be as safe as possible within their own homes. Staff understood how to report concerns about potential abuse, and took action to make sure people were protected from harm. People's needs were assessed and any potential risks to people and staff were identified before any new services commenced. Environmental risks were also assessed within people's homes to help avoid any potential accidents to people who used the service or staff. People who needed staff assistance to take their medicines were supported to do this so their health needs were safely met.

An on-going recruitment programme was in place which showed staff only commenced work once their suitability to support people in their own homes had been checked. Staffing levels were monitored to make sure there were enough skilled and experienced staff to meet people's assessed needs. Staff undertook training in a variety of subjects to support and develop their skills. Staff were provided with regular support to help them carry out their roles which included direct checks of their care practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This included involving people in decisions about their day to day care. People were consulted about the type and amount of care they received and their needs and wishes were understood and followed by staff. Where people required support with their meals and drinks this was provided by staff who followed people’s preferences. People were supported to access healthcare services when required and staff were aware of people's health needs.

Care plans and risk assessments were updated as people's needs changed. People valued the relationships they had built up with staff who regularly provided their care and support. Staff knew what was important to people and had learnt how they liked to be supported with their care. People were positive about how staff respected their privacy, dignity and independence.

The provider and registered manager listened to what people had to say and took action to resolve issues or concerns when they were raised with them. There were systems in place for handling and resolving concerns and more formal complaints.

There was a range of quality monitoring systems in place where senior staff had completed various quality checks and reviews which were documented with improvement actions taken where required. The provider and registered manager met regularly with staff at meetings where they reviewed and reflected on the systems they had in place to manage the service. When action was needed they responded in ways which supported them to keep developing and improving practices for the future. This included reminding staff about areas of their practices which needed to be improved.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

They told us that the staff arrived on time and stayed for the agreed length of time. Comments included: 'They are very caring' and: "Really lovely girls".

People told us they were happy with the staff and that they knew how to care for them. One person told us that: "They know what to do to help me'. Staff we spoke with told us that they had received training and support before they started work at the agency. One staff member told us: 'I've had lots of training here' and 'I feel confident in my job'.

The provider was able to demonstrate that they listened to people who used the service and regularly reviewed and monitored the care to make sure people received appropriate care.