Background to this inspection
Updated
18 October 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 was planned to check whether the provider was 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 the 11 and 12 September 2018 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service and we needed to be sure that the manager would be available at the office.
The inspection team comprised of two adult social care inspectors.
Before the inspection, we reviewed the information we held about the service such as notifications, complaints and safeguarding information. We obtained the views of the local authority safeguarding and contract monitoring team and local commissioning teams. We also contacted Healthwatch to see if they had any feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
When planning the inspection, we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make.
During the inspection, we used a number of different methods to help us understand the experiences of people who used the service. With permission, we visited people living in the ‘extra care’ scheme. We spoke with five people who used the service and three relatives. We also spoke with the registered manager, scheme manager, registered manager and eight members of care staff. We also spoke with an external health care professional.
We looked at a sample of records including four people's care plans and other associated documentation, four staff recruitment and induction records, staff rotas, training and supervision records, minutes from meetings, complaints and compliments records, medication records, maintenance certificates, policies and procedures and quality assurance audits.
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 and dignity was respected and promoted. Privacy and dignity policies and procedures were in place that staff were expected to read and ensure they understood.
Staff were aware of the importance of maintaining and building people’s independence as part of their role and were able to describe to us how they did this.
Staff who were supporting people in the ‘extra care’ schemes encouraged them to join in activities. Whilst this was not part of their role, the registered manager told us staff wanted to go the ‘extra mile’ for people they were supporting.
At this inspection we found that improvements had been made to the provider’s quality assurance systems. We found these were robust and had been effective at identifying any issues or concerns.
People who used the service, staff and others were consulted on their experiences and shaping future developments. We saw that surveys were sent out to people as a means of gaining feedback about the service.