Background to this inspection
Updated
29 June 2018
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 was carried out by one inspector 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. This expert had experience of services providing dementia care.
Prior to and after the inspection, we reviewed information we held about the service including notifications. Notifications are changes or events that occur at the service which the provider has a legal duty to inform us about.
Before the inspection, we asked the provider 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. We reviewed the completed PIR and used this to inform our inspection.
On 22 May 2018 we contacted three people who use the service, four relatives, one friend of a person using the service and a legal executive for two people by telephone. This was followed by a site visit which started on the 4 June 2018 and ended on the 5 June 2018. We visited the office location to see the manager and office staff; and to review care records and policies and procedures. During our visit to the office we spoke with the registered manager, the care manager and the Human Resources manager. On 6 June 2018 we spoke with five staff by telephone
We reviewed a range of records about people’s care and how the service was managed. We reviewed five care plans and associated care records; three staff recruitment records and training and supervision records for seven staff. Other documents we viewed included quality assurance audits, minutes of meetings with staff, and incident reports amongst others.
Updated
29 June 2018
This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older people and younger disabled adults. People living with mental health conditions; learning disabilities, sensory and or physical disabilities. At the time of the inspection there were 43 people using the service, 20 of those people received support with the regulated activity of ‘personal care.’
CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
The service had a registered manager in place. 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. The service was last inspected in December 2016, the rating awarded was required improvement overall.
People and their relatives told us they felt they received a safe service. They said they were cared for by staff who were kind and caring and who were trained. The service they received was responsive and met their needs and there was continuity in the staff that supported them. People valued this as it enabled them to build relationships and develop trust. They told us they felt the service was well managed and they would recommend it to others.
The staff received induction, training, supervision and appraisals in order they could carry out the role to the expected standard. They received support from a team of three senior staff, who they reported were accessible, knowledgeable and effective.
People’s needs were assessed prior to receiving care, a care plan and risk assessments were documented to ensure that any risks were minimised and care was appropriate. The care was regularly reviewed and where required, changes were made.
Where people required assistance with medicines this was provided. However, we found the senior staff were not aware of some aspects of best practice. For example, the information from prescriptions was not always transcribed with sufficient detail onto the Medication Administration Record (MAR). Body maps were not always used to demonstrate where creams should be applied. We discussed this with the registered manager, they took immediate action to rectify the situation and were going to discuss with the franchisor how their training needed to be updated.
The service had safe recruitment systems in place to ensure as far as possible only suitable staff were employed to work with people.
The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
Training was provided on equality and diversity and the registered manager and senior staff told us they would be happy to provide care to anyone with protected characteristics. We found care to be person centre and people were treated equally by the provider. Where appropriate people’s interests and hobbies were supported. Community involvement played a large part of the service provided. The registered manager worked hard to encourage community involvement for the people they cared for.
A quality audit and feedback from people and staff highlighted areas the service could improve in. Where appropriate action was taken to address issues and adjust the service being provided.