Archived: People in Action Domiciliary Care - Solihull

People in Action is registered to provide domiciliary and supported living services to children 0-18, younger adults and older people who may have mental ill-health, dementia, sensory Impairment, physical disability or learning disabilities or autistic spectrum disorder. The regulated activity is for persons who require personal care. At the time of inspection, there were five people who received this activity from the provider. During the inspection, we visited some people in their homes to talk to them.

There was a registered manager 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.

People we spoke with felt safe and happy and felt they could approach staff for support. People looked relaxed and comfortable in the presence of staff. Relatives told us that they were confident that staff protected and kept their relative safe.

Support staff had the training and knowledge in protecting people from abuse. People had appropriate risk management plans. However, some staff did not always follow health management plans concerning people’s physical health.

People’s support needs were assessed and suitable staff numbers were arranged. People were supported by staff that were recruited following appropriate checks and had received the relevant training. We saw through people’s engagement with staff, that they were happy and got on well with the staff.

People received their medicines safely and as prescribed to them.

The provider had systems in place to review people’s support plans. Both people who used the service and their relatives were involved in writing and updating peoples’ support plans.

Staff told us that they obtained consent from people and where appropriate relatives who held the responsibility to make decisions on people’s behalf.

People were supported to buy and cook food that they enjoyed. Staff were aware of people’s dietary needs.

People’s family supported them with healthcare issues.

People and relatives felt that staff were caring and supportive and that most staff knew people well. Staff respected people’s wishes and respected their privacy and dignity.

People were asked about their support plans by staff using easy read documents and communication aids. People received the care they needed from staff to do the things that were important to them.

A complaints procedure was in place with easy read complaints forms. People were aware and knew who to go to if they had a complaint. Although some people told us that, they preferred to share any complaints with their relatives and, let the relative liaise with the provider.

Organisations registered with CQC have a legal obligation to tell us about certain events at their service. With the exception of one recent incident, the provider had made appropriate notifications to the CQC.

Communication between staff and management was not always effective leaving staff feeling with low motivation.

Audits and checks were used to ensure the safety and quality of service provided was maintained but these were not always effective.

We considered all of the evidence we had gathered under the outcomes that we inspected. Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

We saw that when people needed help and support taking their medicines systems were in place that ensured this was done safely.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

The provider had arrangements in place to deal with out of hours emergencies. This meant that people would always be able to get the support they needed when the office was closed.

The provider regularly monitored the quality of the service to ensure it was safe.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their support plans. Staff told us that people's support plans were up to date and reflected their current needs.

It was clear from speaking with staff they had a good understanding of people's care and support needs and they knew them well. We saw people's support plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

Is the service caring?

We spoke with three people being supported by the service and two relatives. We asked them for their opinions about the staff that supported them and their family members. Feedback from people was positive. One person told us, "Yes I like them (the staff). I trust them." Another person said, "I'm o.k. with all of them (the staff)." One relative told us, "Absolutely fantastic staff. They are really on the ball."

When speaking with staff it was clear that they genuinely cared for the people they supported.

People using the service, their relatives and friends involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People's preferences and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw that people's care plans and risk assessments were reviewed on a regular basis to ensure that their changing needs were planned for.

Records we sampled and staff we spoke with confirmed that when there had been a need, referrals had been made to the appropriate health professionals.

People knew how to make a complaint if they were unhappy. We saw that the complaints procedure was available in a variety of formats including easy read with pictures. This meant it was accessible to more people who used the service.

Is the service well-led?

There was no registered manager at the service. The manager of another service was applying for the post. The service was being over seen by the operations manager and a service manager. The operations manager had been working at the service for some time and the service manager had previous management experience. It was clear from our discussions with both managers they were experienced and caring and provided good leadership based on how best to meet the needs of people in an individualised way.

There was a system in place to monitor the quality of the service provided. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

On the day of our inspection we were told the registered manager listed in this report had recently left the service and the manager of the service was applying to become the registered manager.

People and relatives we spoke with told us that the care planning was discussed with them regularly. We saw they were involved with providing their consent regarding the planning of care for people using the service.

We found that the care plans were person centred and reflected people's individual needs. People and relatives we spoke with told us that staff supported people as detailed within their care plans. We found there were risk assessments available to inform staff on how to manage any identified risks for people.

People and relatives we spoke with told us that staff were friendly and supportive.

We spoke with two members of staff about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse.

We found the service was well led and the provider monitored the quality of service being provided.

We found that people had individual care plans, in a picture format that they could understand, which described in detail how staff should care for and support them. We saw that people, or their representatives, had signed their care plans. People we spoke with explained how staff supported them to learn new skills and promoted their independence.

We found that support workers received training and support that enabled them to be effective in their role. One support worker told us, 'The training was very good and I shadowed experienced staff.' The provider's medication policy included detailed guidance for staff and regular testing of staff's competence, to ensure that people's medicines were managed safely.

Support workers we spoke with told us they had copies of people's care plans in the staff rooms at every home site, so they could refer to them anytime. We saw that support workers recorded how they supported people every day, which meant they could identify how people's skills and independence increased over time. We found that people's care plans were regularly updated to show the changes in the level of support needed.