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Inspection Summary


Overall summary & rating

Good

Updated 18 October 2018

This inspection took place on the 11 and 12 September 2018 and was announced.

The service had 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 and associated regulations about how the service is run.

This service provides care and support to people living in their own homes. At the time of this inspection, a total of 123 people were using the service. This was provided where people were living independently in the community (49 people) or in an 'extra care' setting (74 people). Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care living; this inspection looked at people's personal care and support service.

We undertook a comprehensive inspection of iCare GB on the 9, 10,11 and 15 January 2018. The overall rating for this inspection was ‘Requires Improvement’, with well led rated as ‘Inadequate’. We found three breaches of the Regulations in relation to personal centred care, staff support and

supervision and good governance. We also made recommendations about medicines' administration practices and how information is shared with other service when people are transferred to hospital.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question’s, is the service safe, is the service effective and is the service well led? During this inspection we found the necessary improvements had been made and the overall rating has therefore improved to Good.

We saw safeguarding and whistleblowing policies and procedures were in place within the service and the appropriate notifications had been submitted if safeguarding concerns had been raised.

Risk assessments were in place to keep people safe. We saw individual risk assessments were in place in relation to people’s health care needs. We also saw risks in people’s own environment had been considered.

Staff recruitment procedures protected people who used the service. The service had a recruitment policy in place to guide the registered manager on safe recruitment processes. The service managed staffing levels and the deployment of staff to support people to stay safe and meet their needs.

Medicines were managed safely. The service had improved since our last inspection. Staff had received training in administering medicines and their competencies were checked regularly. We found medicines were stored safely, the medicine administration records were completed without any gaps and controlled drugs were safely stored.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

All new staff members were expected to complete an induction when they commenced employment. Training courses were available to staff which were relevant to their roles. Staff members told us and records confirmed that staff members received supervisions and appraisals on a regular basis. This was an improvement from our last inspection. All staff members told us they were able to discuss any training requirements they had.

Support plans that were in place were person centred and evidenced the person had been involved in the development and review of these. These were detailed and contained information about people’s likes and dislikes.

The service ensured that people were treated with kindness, respect and compassion and that they were given emotional support when needed.

People's privacy an

Inspection areas

Safe

Good

Updated 18 October 2018

The service was safe.

All the people we spoke with who used the service, told us they felt safe. The service had safeguarding policies and procedures in place. Training in safeguarding was to be increased to annually.

Risks people presented with had been assessed and up to date risk assessments were in place. Risks within the people�s own homes had also been considered.

Recruitment systems and processes were robust. There were policies and procedures to guide the registered manager when recruiting new employees.

Effective

Good

Updated 18 October 2018

The service was effective.

All the staff we spoke with confirmed they had completed an induction when commencing employment. The registered manager confirmed all staff new to care, were required to complete the Care Certificate.

At this inspection we found improvements in addressing mental capacity, acting in a person-centred way and seeking consent. A number of concerns around people�s capacity had been raised with the local authority.

Staff were receiving regular supervisions to support them in their role. Staff we spoke with confirmed this had improved since our last inspection.

Caring

Good

Updated 18 October 2018

The service was caring.

People we spoke with who used the service told us staff were kind and caring. When visiting the �extra care� schemes, we observed caring and sensitive interactions from staff.

Training records we looked at showed that staff had undertaken training in equality and diversity. Staff effectively supported people protected under specific characteristics.

People who used the service told us that staff encouraged and supported them to be as independent as possible.

Responsive

Good

Updated 18 October 2018

The service was responsive.

We saw people had person centred support plans in place which they had been involved in developing. These were in-depth and covered many aspects of the person�s life.

There was a complaints policy and procedure in place within the service. Staff were aware of this and knew how to respond should someone make a complaint.

We saw the provider had developed hospital passports for people. These included relevant information about the person and would ensure that when the person was moving between services, such as hospital, important information was readily available.

Well-led

Requires improvement

Updated 18 October 2018

This rating had improved to �Requires Improvement�.

Whilst improvements had been made, the provider needs to ensure these new processes are embedded into the service and that quality continues to drive the service.

Improvements had been made to the quality auditing systems in place within the service. These had been effective in highlighting any improvements that were required.

Policies and procedures were in place to guide staff in their roles and were reviewed to ensure they remained current.

Notifications the registered manager should submit to the Commission had been made. This meant we were able to see if appropriate action had been taken to ensure people were kept safe.