20 May 2014
During a routine inspection
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found;
Is the service safe?
People were cared for safely. Risk assessments were in place and regularly reviewed. The service had a comprehensive safeguarding policy. The policy described the types of abuse and guidance on what to do if care workers suspected abuse was happening. This guidance included contacting Oxfordshire County Council (OCC) safeguarding team and the Care Quality Commission (CQC). Safeguarding advice and information was also contained in the service user guide. This included a leaflet issued by OCC entitled "Safeguarding Vulnerable Adults". This contained contact details for a number of support agencies and organisations including Mencap, Oxfordshire Age Concern and the CQC. Care workers demonstrated a good knowledge of the signs and types of abuse and what to do if they suspected abuse was happening.
Care workers were appropriately recruited and selected. The provider conducted background checks and sought references to ensure as far as possible that care workers were of good character. All care workers received appropriate training, including moving and handling, infection control and safeguarding vulnerable adults.
The provider assessed the needs of people who used the service. We looked at five care plans and saw that they were well maintained, up to date and person centred. We saw that assessments were made prior to any care being given. Medical history, allergies, dietary requirements and medication were assessed.
Systems were in place to make sure that managers and care workers learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service to continually improve.
Is the service effective?
The service was effective. People told us that they were happy with the care they received and felt their needs had been met. We spoke with nine people and one relative and asked them about the service. Everyone we spoke with was positive and complimentary. One said "I am very, very happy. The carers are nice and very caring". Another said "I get very good care. The carers are wonderful, they are never late and they know what they are doing". A relative said "they are reliable, very friendly and they are never late".
People were involved in their care. Care plans noted what activities people could do for themselves and where they needed assistance. For example, one plan stated in the guidance for hoisting the person, "the service user may require help to lift each leg. Only assist if the service user is unable to do so for themselves". People were also involved in reviews of care. We saw that people were given every opportunity to comment and influence their review and were fully involved in the process.
Is the service caring?
We found the service was caring. We spoke with nine people who used the service and one relative. We asked them if they felt respected and involved in their care. One person said "they treat me well, I am very happy with them". Another said "they are respectful and the manager calls to make sure I am fine with everything". A relative said "they are respectful. They always make sure my husband is covered when giving care and the manager comes to check all is ok".
We spoke with five care workers and asked them about the service. One said "I love it. I love this job. The people are wonderful". Another said "we are well trained and supported to deliver the best care we can".
Is the service responsive?
The service was responsive. One care plan we looked at highlighted that the person was at risk of pressure sores. We saw that the district nurse visited this person twice a week to manage their condition. Care workers were instructed to ensure the person was well fed and hydrated and that their skin condition was monitored and maintained. We noted that daily fluid charts were maintained and recorded the amount of fluid the person drank on each care visit. Daily care notes were also maintained and recorded that the person's skin integrity was being checked. These were dated and signed by care workers. At the time of our visit this person's skin integrity was being maintained.
Complaints were appropriately dealt with. The provider had a clear complaints policy that stated all complaints would be acknowledged as soon as possible and resolved within 28 days. Details of how to make a complaint were contained in the care plans and in the "service user guide" that was given to all people who used the service.
Is the service well-led?
The service was well led. The registered owner manager was in post. Accidents and incidents were appropriately managed. All accidents and incidents were recorded and investigated. They were recorded electronically and the manager told us this allowed them to look for patterns and trends within the service. The provider sought the opinions of people who used the service. "Client surveys" were conducted every year. Questionnaires were sent by post to people and asked their opinions on a variety of areas that included, punctuality, care, listening, flexibility and respect and dignity, We saw the results for the last survey and noted that the responses were very positive.
During our inspection we looked at the quality assurance systems that were in place. The information reviewed demonstrated that the service was monitored on a consistent basis to ensure that people experienced safe and appropriate support, care and treatment.