Background to this inspection
Updated
9 February 2015
This inspection was carried out by an inspector, a pharmacist advisor and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, we reviewed previous inspection reports to gather information about the service. We reviewed information that we had received from stakeholders and other professionals working alongside the service, including reports from commissioning bodies, and we looked at notifications that providers are required to send to us about certain events that take place in services. We looked at the provider information return (PIR) which we asked the home to submit. This is a form that asks the provider to give some key information about its service, how it is meeting the five questions, and what improvements they plan to make.
We spoke with 20 people who used the service and one relative of a person who used the service, either in person or by telephone. We spoke with the registered manager and interviewed two scheme managers, three team leaders, an activities coordinator and six support workers either in person, by telephone or via an email questionnaire.
During the visit, we reviewed records including eleven people’s care plans and records of care, five staff files and other records relating to the management of the service (such as staff rotas, meeting minutes and reports from audits).
This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?
The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.
Updated
9 February 2015
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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This inspection was announced. We told the provider two days before our visit that we would be coming. At our last inspection, 14 November 2013, we judged the service to be compliant with all the standards that we inspected.
This inspection was announced. We told the provider two days before our visit that we would be coming. At our last inspection on 13 June 2013, we judged the service to be compliant with all the standards that we inspected.
Sanctuary Home Care (London South) provides personal care and support to people living in four supported living schemes across south London. People living in the schemes have their own flats and access to communal facilities. The service provides support to adults of all ages, including those with learning disabilities, brain injuries, long-term health conditions and dementia. At the time of our visit there were approximately 165 people using the service. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People told us they felt safe using the service. They were provided with information about how to keep safe, including recognising and reporting abuse, bullying and discrimination. Staff were trained in safeguarding adults and the service had policies and procedures in place to ensure that the service responded appropriately to allegations or suspicions of abuse. The service ensured that people’s human rights were respected when they did not have the capacity to consent to their care.
Each person who used the service had individual risk assessments and risk management plans so that staff had the necessary information to keep people safe from harm. The assessments were regularly reviewed to make sure the information was up to date.
Robust recruitment and fitness to work procedures were in place to protect people from the risks of being cared for by unsuitable staff. There were systems to ensure that enough staff were employed to meet people’s needs, although many of the staff were not permanently employed.
The service had arrangements to make sure people had the medicine they needed to keep them safe whilst maintaining their independence. The provider carried out regular medication audits in all the services and took steps to ensure staff were competent to administer medicines. However, we identified one person’s medicine was not being recorded accurately and this meant there was a risk that they were not taking it as prescribed.
People were satisfied with their care and said it enabled them to live their lives as they pleased. Staff had access to information, support and training that they needed to do their jobs well. The service provided a training programme that was designed to meet the needs of people currently using the service so that staff had the specialist knowledge they required to care for people effectively.
People’s nutritional needs were assessed and care was planned so that staff knew what support people needed to protect them from the risks of malnutrition and dehydration. This included meeting people’s preferences and cultural needs. Care plans contained information about the healthcare support people needed and records showed they were supported to access healthcare professionals when required.
People told us they had a good relationship with staff and staff were able to demonstrate they knew people well. Staff knew about the importance of treating people with compassion and empathy, respecting their rights to privacy and dignity and promoting equality and diversity. They were able to tell us how they did this and people confirmed this was the case.
People were given information about the service in a format that met their needs. This meant that they were kept informed about their care and had the information they needed to be involved in making informed decisions.
People were involved in planning their care in such a way as to put the person’s needs, preferences and what was important to them at its centre. People were encouraged to take the lead in deciding how to spend their time and to be involved in their local community. The service took steps to ensure that care plans were kept up to date and involved people in reviewing them so that any changes people wanted or needed were made.
The service had several methods through which people could express their views and concerns so that different ways of communicating were catered for. This included meetings, surveys and being asked verbally as part of care reviews and quality checks. The service responded promptly to concerns and complaints and made sure people were satisfied with the outcomes.
People were involved in the running of the service. This included involving people in staff recruitment, complaints management, policy development and changes to the service. This meant there was a culture of inclusion and people’s input was valued. People were encouraged to work together to decide how the service should be run. Staff felt able to raise any concerns they had and had the opportunity to express their opinions.
The provider had a number of audits and quality assurance programmes in place. These included action plans so the provider could monitor whether necessary changes were made and ensure high standards were being maintained. The service had mechanisms in place to learn from incidents and adverse events.
The service had links with other organisations and expert advice to enable them to deliver care in line with current best practice guidance. Managers monitored the quality of care that staff were providing through observation and supervision. Staff were given the opportunity to discuss good practice in meetings.