Background to this inspection
Updated
31 December 2016
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 10 and 18 November 2016 and was announced. 48 hours’ notice was given to the agency of our intention to visit so that we could be sure that people employed by the registered provider would be available to assist us.
The inspection was carried out by one adult social care inspector.
As part of our inspection, we asked registered providers to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR was returned to us when we asked.
We contacted local authority commissioning groups and the local safeguarding team about information they held in respect of the registered provider. They did not have any concerns.
We reviewed all the information we had in relation to the service. This included notifications, comments, concerns and safeguarding information. Our visit involved looking at six care plans and other records such as six staff recruitment files, training records, policies and procedures, quality assurance audits and complaints files.
We spoke to eighteen people who used the service. Discussions were held by telephoning people. We spoke to seven members of staff as well as the registered manager and members of the quality assurance team.
Updated
31 December 2016
We carried out an announced inspection of The Cheshire and Greater Manchester Regional Office (CIC) on the 10 and 18 November 2016.
Cheshire & Greater Manchester Regional Office is registered as a domiciliary care agency (DCA) and is part of Community Integrated Care. Community Integrated Care is an organisation who provides support and personal care to young adults and children living in the community in supported living, extra care facilities and in people’s own homes. The service currently provides support covering a large geographical area covering: Halton; Wigan; Knowsley; Cheshire/Wirral and St Helens. CIC is a registered charity operating on a not for profit basis, established since 1988 and also a company limited by guarantee.
The main office is located within a residential area of Widnes and there is ample parking within their own car park for visitors.
A registered manager was in post. 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.
We last visited this service on 20 and 25 November 2013. At that time the registered provider met all the regulations we used to assess the quality of support.
People told us that they felt safe with the staff team and had no concerns about the support they received. Staff demonstrated a good understanding of protecting vulnerable adults from abuse and had received training in this and whistleblowing.
Recruitment procedures were robust with all required checks made before new staff supported people.
Risk assessments were in place and these related to all aspects of people’s lives including risks posed by the environment and through the support provided. All risk assessments were up to date. Emergency plans were in place outlining how each person would be assisted in the even to the need to evacuate or a wider environmental emergency.
Medicines were managed safely. People told us that they received their medicines when they needed them and that they were never missed. All staff had received medication training and had their competency to do this checked.
Staffing levels were maintained. Systems were in place to ensure that the right number of staff were available to meet people’s needs.
A structured induction process was in place. This involved training new staff and ensuring that they were competent to support people alone.
People told us that the staff team knew what their needs were. Staff received training appropriate to the needs of people. Staff received supervision and annual appraisals to ensure good practice.
While the nature of the service did not deal directly with deprivation of liberty safeguards, staff had received training in this and demonstrated an understanding on how this affected people in their daily lives.
The nutritional needs of people were met. This included an indication of people’s likes and dislikes as well as the level of support they required in preparing meals. Where more specialist nutrition was necessary, staff had received training in this.
People felt cared about by the staff team and stated that they were free to make decisions about their daily lives. Staff were able to outline the main priorities of their work and these included respecting people’s homes, promoting their privacy and supporting them as much as possible.
People who used the service were given information about the support they wold be given.
People had access to their care plans. All care plans were accompanied by an assessment of need which gave a very detailed account of each person’s life, wishes and routines. All care plans were reviewed monthly with a wider annual review each year. All care plans had daily records which were detailed.
People knew how to make a complaint and a complaints procedure was in place ensuring a robust system of reporting concerns.
The registered provider demonstrated an accountable and transparent approach to managing the service. Staff felt supported and were given the opportunity to influence the running of the service.
People who used the service and their relatives were invited to comment on the support they received and comments were positive.
The registered provider had a robust auditing system in place to ensure that quality of support was maintained.