Background to this inspection
Updated
27 May 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.
One adult social care inspector carried out this announced inspection on 07 and 08 March 2016.
Before the inspection we reviewed all of the information we held about the service, such as notifications we had received from the service and also information received from the local authority who commissioned the service. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. We also spoke with the responsible commissioning office from the local authority commissioning team about the service.
The registered provider was asked 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.
During this inspection we visited three people in their own homes and looked at each of their care records and checked their prescribed medicines. These people had limited communication skills and this affected the questions which we could ask them. We also spoke with four relatives and one adult social care professional over the telephone.
We visited the registered provider’s office in Middlesbrough to speak with staff and to look at records. We also spoke with staff when we visited people in their own homes. During the inspection we spoke with the registered manager, development manager, three team leaders and four care staff. We looked at four staff recruitment records, ten supervision and appraisal records and all staff training records. We also looked at a range of records which related to the day to day running of the service. At the time of our inspection there were three team leaders, 36 care staff and 12 bank care staff employed at the service to provide care and support to 24 people.
Updated
27 May 2016
This inspection took place on 07 and 08 March 2016. The registered provider was given 48 hours’ notice prior to inspection because the service provided domiciliary care services. This meant we could be sure that the registered manager and people’s care records would be available for inspection. This also gave the registered provider time to gain consent from people who used the service and their relatives for us to speak to them by telephone.
ESPA provided domiciliary care services for people living in their own homes. The registered provider’s office was located in Middlesbrough. At the time of our inspection there were 24 people using the service. The registered provider employed an operations manager, registered manager and eight staff.
ESPA had been running for many years. There was an experienced and stable staff team in place. The service recruited staff when vacancies arose or when new people started to use the service. There registered manager had been in place for many years. 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.
Supervision and appraisals were not up to date for all staff and we identified gaps in these records.
Risk assessments were in place, however had not always been regularly reviewed.
Staff understood and followed safeguarding procedures. Safeguarding alerts had been made when needed.
Emergency procedures were in place for staff to follow and personal emergency evacuation plans were in place for everyone.
People were recruited safely. People and their relatives were involved in the recruitment process when appropriate to do so.
There were sufficient staff on duty to provide care and support to people. Staffing levels changed to meet the needs of people.
There were sufficient quantities of prescribed medicines in place. Staff were trained to dispense prescribed medicines to people.
Health and safety checks of ESPA office environment were up to date.
Training was up to date and included specialist training to meet individual needs.
People were supported to make healthy choices and staff worked around people’s limited food choices. Monitoring was in place for those who needed it.
People had regular contact with a range of health professionals.
Each person had a hospital passport in place which provided staff with important information about each person.
People were supported by staff to live at home with their relatives or independently in the community.
Relatives spoke highly of staff. From our observations we could see that staff and the people they cared for got on well with each other.
Staff gave people the time they needed to make decisions. People were encouraged to make decisions about all aspects of their day.
People’s privacy and dignity was respected and maintained.
People and their relatives were involved in planning their care. Staff knew people well and this meant they could tweak care and support when needed.
People and their relatives were invited to be involved in reviewing care. People had choice about all aspects of their lives.
The people we visited and spoke with did not understand how to make a complaint. However staff and their relatives told us complaints would be made on their behalf when needed and the relevant professionals involved.
Staff and relatives spoke positively about the service. Staff told us they enjoyed working at the service.
Relatives told us they felt the service was approachable and responsive.
Meetings for people, their relatives and staff took place.
A survey had been carried out and an action plan developed.
Relatives and staff told us ESPA was open and transparent with them. Everyone told us they felt able to voice any concerns.
The service and staff knew what was expected on them and took action when appropriate.
We found one breach in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the premises and equipment and records. You can see what action we told the provider to take at the back of the full version of this report.