Background to this inspection
Updated
11 January 2019
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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.
This announced inspection was carried out on 13 December 2018. The provider was given 48 hours’ notice because we wanted to make sure the registered manager and staff would be available to speak with us. The inspection was carried out by one adult social care inspector.
Before the inspection we reviewed any information we held about the service in the form of notifications received from the provider. We also reviewed any safeguarding or whistleblowing information we had received and any complaints about the service.
Prior to the inspection the service completed a Provider Information Return (PIR), which is a form that asks the provider to give some key information about the service.
As part of the inspection we spoke with the registered manager, the directors, a care coordinator, the office staff and four staff members. We also spoke with five people who used the service and a relative; this was to seek feedback about the service provided from a range of different people and help inform our inspection judgements. We also spoke with the local authority commissioning team, the safeguarding team and Healthwatch Bolton. Healthwatch is the national consumer champion in health and care. No concerns were raised.
During the inspection we viewed four care plans, five staff personnel files, policies and procedures and other documentation relating to the running of the service, such as satisfaction surveys, complaints, spot checks/observations and risk assessments.
Updated
11 January 2019
The inspection took place on 13 December 2018 and was announced. This was the first inspection of this service since registering with the Care Quality Commission (CQC) in October 2017.
This service is a domiciliary care agency and provides personal care and support to people living in their own houses in the community. It provides a service to people living with dementia, older people, learning disabilities or autistic spectrum disorder, physical disabilities and sensory impairment.
On the day of the inspection there were 63 people using the service of which 43 were receiving assistance with personal care and 23 people were supported with other daily living tasks. The office is situated in the Great Lever area of Bolton.
There was a registered manager in place. 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.
People who used the service felt safe with the people who supported them. Staff files showed the recruitment system to be satisfactory and people employed had been checked with the Disclosure and Barring Service (DBS) to ensure they were suitable to work with vulnerable people. Some of the staff had worked with the registered manager at another agency and some of the DBS checks had been carried out by that agency. The registered manager was in progress of ensuring that DBS checks were now being completed by Orchid Home Support Care.
There were enough staff to meet the needs of people who currently used the service. Systems were in place to monitor that staff had arrived at a person's home. This helped to ensure visits were not missed.
The service had a relevant and up to date safeguarding policy and procedure and all staff had received training in safeguarding. The medicines systems were safe and staff had undertaken appropriate training in medicines administration.
Records showed a thorough induction programme for new staff. New staff shadowed an experienced member of staff until they felt confident in their role. Further training was on-going and staff were required to complete regular refresher courses for essential subjects.
We saw that staff were taught to deliver non-discriminatory and cultural awareness to ensure that
people's cultural and religious beliefs were respected place.
People's nutritional and hydration needs were clearly documented, along with any allergies and special dietary needs.
We saw from care plans we looked at that independence was promoted and people told us their dignity and privacy were respected.
Care files we looked at were person-centred and people's choices for their care and support were respected. Risk assessments and care plans were reviewed on a regular basis. Any changes were clearly documented within the care files. Activities, such as accompanying people to go out in to the community were facilitated by the service where possible.
The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA).
People who used the service told us the staff were kind and caring. Staff we spoke with were positive about their jobs and were complimentary about how the service was managed.
There was a service user guide which included relevant information about the service.
Feedback was sought from people who used the service. Home visits from the registered manager and quality assurance surveys were completed.
There was an up to date complaints policy and procedure and complaints were dealt with appropriately.
Regular staff supervisions were carried out and there were staff meetings held on a regular basis. We saw records of regular observations of staff competence which were undertaken by the management.
There were a number of audits carried out on a regular basis. All were followed up with appropriate actions where required.