Archived: ARCH

Prior to our visit we reviewed information we had received from the provider.

During the inspection we spoke with people who used the service and asked them for their views. We also spoke with four staff members and the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. We also spoke with a visiting health care professional.

We looked at some of the records held in the service including the care files for all 10 of the people who used the service. We observed the care and support people who used the service received.

The summary below describes what people using the service, the staff and visiting healthcare professional told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found people's needs had been assessed and individual care plans drawn up to meet people's needs. Risk assessments were in place to keep people safe.

Arrangements were in place to deal with foreseeable emergencies. We were told by staff members we spoke with that they were able to contact a manager when needed.

People told us there were enough staff to meet their needs. One person we spoke with told us, 'Staff are always available when I need them'.

We found the service was safe because people were protected against the risks associated with medicines. The provider had appropriate arrangements in place to manage people's medicines safely.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. One person told us, "I've been in the care system for years but the freedom I have now is better'.

We found the provider worked closely with people using the service and other professionals and adapted care plans to meet people's needs.

We found improvements had been made since our last visit in June 2013 to the care records. During our visit we saw care records were accurate and information was easy to find.

Is the service caring?

We found people who used the service understood the care and treatment choices available to them. We saw people had been involved in agreeing to the levels of care and support they needed. We spoke with people who told us they had agreed how they would be cared for.

Staff we spoke with told us they considered meeting people's needs to be the most important part of their role. One staff member said, "We try to make sure people are well cared for and work closely with other professionals to develop plans to meet people's needs'. A visiting healthcare professional we spoke with confirmed this was the case.

Is the service responsive?

We found the provider had listened to people's views and made changes to the service provided as a result. One person we spoke with told us, "We regularly change how things go for me'.

Is the service well-led?

People told us the provider regularly sought their views and made changes to the service as a result.

We found the provider monitored the health and safety of people using the service, staff and others. We were told by care staff that health and safety was seen as important by the provider.

We found that people were not being protected against the risks associated with medicines because not all care workers had received training on the subject. We also found that care workers weren't clear what action to take in the event of a medication error or someone refusing to take their medication.

The agency had effective recruitment procedures in place to ensure that only suitably skilled or experienced people of good character were employed as care workers. We also found that the agency had an effective system to regularly assess and monitor the quality of service that people received.

People were at risk of unsafe or inappropriate care or treatment because information about them was either incomplete or could not be located promptly. However we found that people were receiving individualised care and support that met their needs.

All of the six people we spoke with had positive comments about the care workers and the agency in general. One told us, "I'm happy to be here, knowing I have the right people to look out for me." Another said, "It's definitely a step forward for me here. The staff are professional and helpful."