Background to this inspection
Updated
20 December 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: One inspector carried out the inspection.
Service and service type: The service is a 'domiciliary care agency' providing care to people in their own homes. At the time of inspection, the service supported nine people.
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 72 hours' notice of the inspection because we wanted to make sure someone was available to speak with us. We visited the registered office on 23 October 2019 and visited three people in their homes.
What we did before the inspection: We used information we held about the service which included any notifications that they sent us to plan this inspection. Notifications are used to inform us about certain changes, events or incidents that occur. The Provider Information Return (PIR) had not been completed. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, the provider had evidenced they had attempted to complete this and we therefore gave opportunities for them to update us throughout the inspection. We requested feedback from local authorities, health and social care professionals about information they may wish to share with us.
During the inspection: We spoke with the three people in their homes and one relative. At the office we spoke with the office administrator, a senior carer and the registered manager who was also the owner of the business. We looked at care files belonging to six people who used the service and recruitment files and personnel files for all five care staff including training records. We viewed records and documentation relating to the running and monitoring of the service.
After the inspection: We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
20 December 2019
About the service: This service provides care and support to people living in their own homes within the community. At the time of the inspection there were nine people using the service.
People's experience of using this service: Sufficient and effective quality audits had not been completed by the provider. People were not always safe from harm due to risks not being managed and recorded safely. Guidance for staff on people's as required medicines was not in place. New staff had not received mandatory training and longer term staff had not had refresher training or their competency assessed. All staff had not received regular formal supervision to carry out their duties.
Failure to operate a robust governance framework was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.
Staff were motivated to provide care based on people's choices, preferences and likes. However care plans did not always reflect this. People had good relationships with the staff who protected their rights to lead as normal a life as possible. People and relatives told us the office staff do their job well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People were supported to do the things they wanted to in the way they wanted. Staff dedication was praised by people who received care. Staff had completed safeguarding training. People were supported to keep their homes clean and staff followed good food hygiene practice. Sufficient numbers of staff were employed so that people's needs were met. Safe recruitment practices had been followed.
Care records reflected people's current needs but required a more person centred approach. Records of people's and relative's feedback showed us they were satisfied with care received and staff were kind and caring. People's privacy and dignity were respected. Staff promoted people's independence in all aspects of their life. No complaints had been received. People told us they would contact the office if they had concerns. There was a registered manager in charge of day to day operations, whose was in regular contact with people, relatives and staff.
Rating at last inspection: The last rating for this service was good (published 29 April 2017)..
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.