We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
The inspection was completed by one inspector. We spoke with a person and their relative who received a service in their own home. We spoke with two members of staff. This is a summary of what we found.
Is the service safe?
Risk management plans identified most of the hazards and noted how to reduce and minimise these. We found staff were following these and used any equipment which had been provided to safeguard people from risk of falls. People were not put at unnecessary risk and were offered choices remaining in control of decisions about their care and support.
Safeguarding procedures were in place and staff had completed training in the safeguarding of adults. Staff understood how to make sure people were safe and protected from abuse. A relative said: "feel totally safe" and "I have no concerns about the care".
Staff personnel records did not contain all the information required by the Health and Social Care Act. This meant the provider could not demonstrate the staff employed to work for their service were suitable and had the skills and experience needed to support people. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
Is the service effective?
People told us they were happy with the care being provided. A relative told us: 'I couldn't have coped without them.' Staff had a good understanding of the needs of people with dementia. They responded to people calmly and sensitively.
Care records were based on the person's assessment of need. These reflected their wishes and preferences about how they wanted to be supported. A relative said: 'very happy with care' and 'staff are very good'.
Is the service caring?
We observed staff treating people respectfully and with kindness. People were offered choices about the way their care was delivered. Staff encouraged and supported people to complete tasks at their own pace.
A relative said: "the continuity is what I like and for (name provided) this is most important." We observed two of the three staff who supported this person carrying out tasks sensitively and with shared humour.
Is the service responsive?
A complaints system was in place and copies supplied to people at the start of their service. No complaints had been received. The registered manager had almost daily contact with people and discussed the quality of service provided with them. Where any issues were raised these were discussed with other agencies or services where appropriate.
The registered manager described their admissions process and how assessments were completed over two or three visits. Input from social and health care professionals was vital to this process. A service was then developed to ensure a timely and safe transition from other agencies back into their home.
Is the service well led?
As a new service the quality assurance system was still developing. The registered manager received feedback from people who used the service, their relatives and staff directly. This was used to monitor and evaluate the service being provided. Future plans included a survey enabling people to give formal feedback.
Staff worked alongside the registered manager who led by example. They were clear about their roles and responsibilities and delivering a service of a high quality.
We found inconsistencies with some records. Policies and procedures had not been dated or signed. Care plans and risk assessments did not provide an accurate personalised account of the care being delivered. This meant people could potentially not receive their care and support in the way which they preferred or which kept them safe from harm. Some other documents referred incorrectly to other organisations and needed to be updated. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.