7 March 2016
During a routine inspection
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.