Background to this inspection
Updated
25 November 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We carried out the inspection visit on 20 October 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.
The inspection team consisted of an inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give key information about the service, to detail what the service does well and improvements they plan to make. We also reviewed information that we held about the service to inform and plan our inspection. This included information that we had received about the service as well as statutory notifications that the provider had sent to us. A statutory notification contains important information about certain events that they must notify us of. We contacted Healthwatch Leicestershire who are the local consumer champion for people using adult social care services to see if they had feedback about the service. We contacted the local health commissioners who had funding responsibility for some of the people who were using the service.
We spoke with 16 people who used the service over the telephone. We spoke with the provider, deputy manager, a senior staff member and three care workers. We looked at the care records of five people who used the service and other documentation about how the service was managed. This included policies and procedures, staff records, training records and records associated with quality assurance processes.
Updated
25 November 2016
We carried out the inspection on 20 October 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.
The service is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our inspection 36 people used the service.
The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider was advertising to recruit a new manager at the time of our inspection.
People told us that they felt safe in their own home. Risks associated with people’s needs and providing care in the home environment had been assessed. Staff understood their responsibility to make checks within people’s home and of equipment to keep themselves and people safe.
Where accidents and incidents had occurred action had not always been taken to investigate and prevent further occurrences. The provider told us they would make improvements.
The service was not consistently working to the requirements of the Mental Capacity Act 2005.Where people had the capacity to make decisions about their care and the support that they received they were involved and their opinions sought and respected.
There was a recruitment policy in place which the provider followed. We found that all the required pre-employment checks were being carried out before staff were to commence work to make sure they were suitable.
Staff received training to meet the needs of the people who used the service. Staff felt supported and received guidance from the deputy manager.
People received their medicines as required and medicines were managed and administered safely. People were supported to maintain their health and wellbeing. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have sufficient to eat and drink.
Staff knew people well and treated them with kindness and compassion. People received a consistent level of support and received their care at agreed times. People that we spoke with said that they would recommend the provider to others.
The care needs of people using the service had been assessed. Care plans included information about how people would like to receive their support. Staff had a clear understanding of their role and how to support people who used the service as individuals. People’s care requirements were reviewed.
Staff felt supported. They were clear on their role and the expectations of them. Most people who used the service and staff felt they could talk to the office staff and had confidence that they would address issues where required. People told us that they knew how to make a complaint if they needed to.
There were systems in place to monitor the care that people received however these were not always consistently followed. The provider demonstrated that they were keen to improve systems to develop the service.
The provider was not clear about their responsibilities to report significant incidents to CQC. The provider had updated all of their policies and procedures as well as the staff hand book and service user guide to ensure that staff and people using the service had current and relevant information about the service and how it was run.