Background to this inspection
Updated
31 May 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of an adult social care inspector and an expert by experience on the first day of the inspection and one adult social care inspector on the second day of the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Belong at Home – Macclesfield is a domiciliary care agency that provides care to people in their own homes. They support adults with a variety of health needs.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 2 working days notice of the inspection visit because the manager is sometimes out of the office supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started on 7 May 2019 and ended on 10 May 2019. We visited the office location on 7 and 10 May 2019 to see the manager and office staff; and to review care records and policies and procedures. We conducted phone calls and home visits on both days of the inspection.
What we did:
Before the inspection, we reviewed information the provider had sent us since the last inspection. We assessed information we require the provider to send us at least annually within their provider information return (PIR). This provides key information about the service, what the service does well and the improvements they plan to make. We considered information about incidents the provider must notify us about and looked at any issues raised in complaints and how the service responded to them. We requested information from the local authority commissioners. We used all this information to plan our inspection.
During the inspection we spoke with eleven people using the service to ask about their experience of care and seven family members. We also spoke with the registered manager, practice development facilitator and four support staff. We undertook three home visits and spoke to a healthcare professional who regularly visits people and works with the service.
We looked at four people’s care records and a selection of other records including those related to medicine administration, recruitment and the quality and safety of the service.
Updated
31 May 2019
About the service: Belong at Home Macclesfield is a domiciliary care agency which supports people in their own homes. At the time of our inspection 38 people were in receipt of the regulated activity ‘personal care’. They provided services to adults with a variety of health needs.
People’s experience of using this service:
People felt safe and spoke of being supported by a consistent staff team who knew them well and took the time to chat with them on visits and were on time and never rushed.
Staff had travel time built into their rotas in order that they could get between visits and still arrive at each call on time. Where they noticed changes in people’s health needs and people needed more time within visits, staff were able to raise this, and call times would be adjusted accordingly. Calls were monitored via a telephone system which activated the office staff if a member of staff had not turned up at a call and action could be taken to resolve this.
Risks were managed safely, and staff had clear instructions on how to keep people safe. They were aware of safeguarding policies and what steps to take if they suspected someone may be at risk of harm.
Medicines were managed safely, although we noted there was some written guidance on medication that is given when necessary in care plans, this could be clearer. The registered manager agreed to improve this guidance immediately.
Staff were recruited safely and given enough support to develop their knowledge and skills to do their job. They underwent a tailored induction into the company and ongoing training to do their job. They spoke with pride of working for Belong and felt that the provider invested in their development and supported them in their roles.
People and their relatives spoke of staff who were kind, patient and caring. They commented that staff knew them well, always asked permission before carrying out any tasks and often asked if there was anything else that they could do. Family members spoke of staff communicating well with them about any changes to their loved one’s health or wellbeing, so they felt secure in the knowledge their loved one was receiving good care.
Care plans and documentation was clear, detailed and was regularly reviewed. People and their relatives felt involved in the care as regular reviews were held to discuss their care.
The service was responsive to people’s needs and flexible. People and their relatives could request additional calls, and these were accommodated by the service.
People were clear on how to make a complaint and were confident that their concerns would be acted upon.
People, relatives and staff were positive about the registered manager and felt that the service was well run. They considered that the service displayed the provider’s values of ‘putting customers at the heart of all we do’.
The provider had robust quality assurance systems that were effective at identifying areas for improvement and these were acted upon in a timely manner. Regular staff meetings were held so staff were kept up to date with any changes and good practice. The service worked well with other professionals and acted upon advice to support people’s health and wellbeing.
Rating at last inspection: Good (Report published 27 October 2016)
Why we inspected: This was a planned comprehensive inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk