Background to this inspection
Updated
27 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consistent of one inspector and one assistant inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service four days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used this information to plan our inspection.
The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.
During the inspection
We spoke with four people who used the service and one relative about their experience of the care provided. We spoke with two members of staff, including the registered manager. We spoke to one professional.
We reviewed a range of records. This included three people’s care records and additional medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke to two staff members.
Updated
27 July 2019
About the service
Julie Blackburn is a care at home service. The service provides personal care to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection, nine people were receiving personal care.
People’s experience of using this service and what we found
Risk assessments were not always in place or completed comprehensively to minimise risks to people. People told us staff mostly turned up on time, however there was a lack of monitoring of call attendance and call times.
There was a lack of governance systems in place to monitor and improve the quality of the service. Required records were not always readily available.
People told us they were supported by staff who were knowledgeable. However, staff had not completed all training. Records of staff induction were not kept.
We have made a recommendation about induction and training.
People told us they felt safe with the staff who supported them. People were supported by a consistent staff team.
People received good support to maintain a healthy balanced diet and, where appropriate, the provider worked closely with other health professionals to support people with their health and wellbeing.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported by kind and caring staff who knew them well.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update. The last rating for this service was requires improvement (published 24 July 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection, enough improvement had not been made/sustained and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a continued breach in relation to governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.