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Archived: Totnes Domiciliary Care Service (South Devon Support Service)

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Inspection report

Date of Inspection: 4 September 2012
Date of Publication: 4 October 2012
Inspection Report published 4 October 2012 PDF | 85.46 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 4 September 2012, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service and talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

We found that people's physical, social and mental health care needs were planned and delivered in a way that helped to ensure their safety, welfare and wellbeing.

People were positive about the care they received. One person said "I am happy here. The staff help me if I need it but I am OK most of the time doing things on my own”.

People told us that they saw the doctor if they need to and staff took them to the surgery in the car. Records showed that people were supported to access NHS services where necessary. Records also showed that there was effective communication shared with speech and language therapists, psychologists, GPs and other health care professionals. Staff at the Totnes office also explained they had good working relationships with the Learning Disabilities link person at the local hospital. This meant that people received effective care if they were in hospital and meant that hospital staff had up to date information about the person in their care.

Care records and photographs in people's homes showed that activities were tailored to what people's abilities and hobbies were. Examples included hot air balloon rides, shopping trips, and regular attendance at day centres. On the day of our inspection one person was going for a pub lunch, another was making jelly and others were helping staff make a poster.

During our inspection of people's homes we observed that people appeared relaxed in the company of staff and staff were discreet when they supported people. All interactions were positive. This resulted in the people staff were supporting or were talking with appeared relaxed. We saw humour and appropriate displays of affection shared between people and staff.

The care staff we spoke with had a good knowledge of what people's support and care needs were and how to meet those needs. They told us that they got the information they needed from other staff during handovers between shifts or from the communication book. They also said they had easy access to the care plans and had read them and were able to update them when necessary. They said that communication was very good and they felt they had the information they needed to enable them to meet people's needs.

We looked at care plans and risk assessments in both the Totnes and Plymouth Office. We saw that these records were copies of those found in each person's home. These contained assessments showing what people's support needs were. Each person had a set of detailed risk assessments which were linked to their support plans. The managers for each office explained the care records had been standardised across the organisation. Staff told us this had made finding information easier. Staff also told us they were encouraged to update care records as changes occurred. They said this involvement had improved communication and safety for people because staff were more aware of each person's risks. Staff also told us they had received training on identifying risks and instructions on how to complete and update risk assessments. One manager said “It was down to us (the managers) to make sure risk assessments had been done but all staff have ownership of this.”

Risk assessments were different for each person. Examples included risks of people managing their own finances, risks of behaviours that could challenge or affect members of the public, protection from abuse and health issues including epilepsy, mobility and risks of choking or swallowing.

We saw that a “red alert” page in the front of each persons care records warned staff to the persons immediate risk and directed them to read the support plan and risk assessment. One example included making sure staff had watched an instructional video on a specific issue before caring for one person.

Where a risk was identified there was a plan in place describing how staff would manage the risk. We saw that additional changes had been made within the review time where a change had occurred or deterioration n