15 and 23 January 2015
During a routine inspection
We undertook this inspection over two days on 15 and 23 January 2015 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service. The inspection was planned to check whether the registered 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.
The service was last inspected on 23 November 2013 and was meeting all the regulations assessed during the inspection.
The registered provider is required to have a registered manager in post and on the day of the inspection. There was a manager registered with the Care Quality Commission (CQC); they had been registered since 10 0ctober 2013. A registered manager is a person who has registered with the Care Quality Commission to manager the service and has the legal responsibility for meeting the requirements of the law; as does the registered provider.
Emerald Care Services is a care agency. The agency provides personal care and support services to people living in North Lincolnshire. Services provided range from a few hours support several times a week, to 24 hour support every day. People who used the service included; older people, people with dementia, learning disabilities, autistic spectrum disorder, mental health needs, physical disabilities, sensory impairments and people who misused drug and alcohol.
People who used the service told us they had positive relationships with their carers and their care was delivered to a high standard.
Staff knew the people they were supporting and provided a personalised service. Care staff received regular training and were knowledgeable about their roles and responsibilities. They told us they felt they had the skills, knowledge and experience required to support people with their care and support needs.
Disposable gloves and aprons were provided by the organisation for all staff. Staff told us there were adequate supplies of these and where allergies to products had been identified, suitable alternatives were found and provided.
People were at the heart of the service and the agency did their upmost to organise care and support to suit their individual needs. For example, people who used the service who required a high level of support from the agency had a team of carers allocated to them in order to provide continuity. Some people who used the service had been involved in the staff selection process.
Staff knew how to protect vulnerable people from abuse and they ensured the equipment they used in people’s homes was regularly checked and maintained. Risk assessments were carried out for known risks to people to ensure staff knew how to manage these safely and support people to make sensible decisions.
People’s human rights were protected by staff who had received training in the Mental Capacity Act 2005. We saw where a person may not have the ability to make a certain decision an assessment was completed to see if they understood the choice they were asked to make. Where people were not able to make a decision we saw decisions had been made in their best interests by family members and professionals involved in their care.
The registered provider had policies and systems in place to manage risks, safeguard vulnerable people from abuse, recruit staff safely and for the safe handling of medicines.
Assessments had been undertaken to identify people’s health and support needs. Care plans had been developed with people to identify how they wished to be supported and to provide guidance for staff, in order to meet their needs in their preferred way.
There was a strong leadership which put people first, set high expectations for staff and led by example. The service had an open culture, a clear vision and values which were put into practice. Staff were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.
Staff were enabled to develop their skills through a process of continuous learning and development. This consisted of an in depth induction, training and appraisal. Staff were encouraged to reflect on their practice through regular assessment of their practice and supervision.
People who used the service were encouraged to raise concerns and report incidents. People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. Incidents were reviewed regularly to establish if changes needed to be made and what worked well for people. Where changes were identified as being required, these were acted on and implemented.
The registered provider had a robust quality monitoring systems in place to monitor the quality of care.