Background to this inspection
Updated
2 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
This inspection took place on 21 June 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that they would be in.
The inspection visit was carried out by one inspector.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well, and improvements they plan to make. This was returned to us by the provider and used to inform our judgement. We reviewed the information we held about the service. This included statutory notifications regarding important events which the provider must tell us.
During the inspection we spoke with 14 people who used the service and 2 relatives. We spoke with six staff who delivered care and support to people, the registered manager, the deputy manager, the care co-ordinator and the training and development officer.
We looked at the care records of eight people who used the service. These records included care plans, risk assessments and daily records of the support provided. We looked at four staff recruitment files and staff training records. We looked at records related to how the quality of the service was monitored. These included quality audits and checks, minutes of meetings, and feedback provided by people who used the service and their families.
Updated
2 August 2018
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service provides care and support to adults with a range of needs.
This inspection took place on 21 June 2018 and was announced. At the last inspection this service was rated as good. At the time of our inspection visit 54 people were using the service. At this inspection we found evidence to support the rating of good.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 had not consistently followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's capacity to agree to their care and support had not been fully considered to ensure that any decisions were made lawfully and in people's best interests. The registered manager undertook to address this shortfall following our inspection. People's consent was obtained before they were supported where they were able to do this.
People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed and preventative action was taken to reduce the risk of harm to people.
People were supported with their medicines in a safe way. People’s nutritional needs were met and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.
People were protected by safe recruitment procedures to help ensure staff were suitable to work in care services. There were enough staff to meet people's needs. Staff received training for their role and ongoing support to work effectively.
People were involved in their care as far as possible and people were encouraged to remain independent. Care plans were regularly reviewed and updated as people’s needs had changed. Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure they were responsive.
People and their relatives were happy with staff who provided their personal care and had developed positive trusting relationships. The service worked towards people having consistent support staff to ensure they felt comfortable and safe.
People, relatives and staff were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any required improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to.
The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.
The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. People's health and well-being was continuously monitored at the service.
Incidents which took place at the service were appropriately acted on and the relevant agencies notified as required. However, improvements were needed in relation to how incidents were monitored.