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Blackpool North, Cleveleys and Fleetwood Home Instead Good

Reports


Inspection carried out on 9 January 2018

During a routine inspection

Blackpool North, Cleveleys and Fleetwood Home Instead are a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection visit there were 30 people receiving a service.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and the Caring domain had improved to Outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We looked at how accidents and incidents were managed. We found some documentation had not been fully completed and did not always have evidence of actions taken. We have made a recommendation around this.

We looked at how medicines were managed at the service. We found some information required updating. We have made a recommendation about this.

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. However, we found documentation around this was at times conflicting. We have made a recommendation about this.

We saw evidence quality monitoring was being undertaken at the service. However, we found this process was not always robust and effective. We have made a recommendation about this.

We found people were protected from risks associated with their care because the registered provider had completed risk assessments. We received consistent positive feedback about the staff and about the care people received.

We found there was a strong visible person centred culture at the service. The service ensured staff focussed on building and maintaining open and honest relationships with people and their families. People were supported to undertake their hobbies by staff. One person told us, “They take my relative to bingo, the cinema or the pub.”

Staff had a good understanding of protecting and respecting people's human rights. Some staff had received training which included guidance in equality and diversity. We discussed this with staff; they described the importance of promoting each individual's uniqueness.

The management team and staff discussed the people they supported with affection, respect and clear insight into their unique personalities, needs and requirements. This included knowledge of people's personal backgrounds, their hobbies and interests and the emotional support they needed on a day-to-day basis. Staff and management showed compassion and empathy toward people who used the service. One example we saw was for a person who required further support due to sensory loss. The service had implemented the use of a whiteboard to write on in larger letters so the person could see this.

There was a clear vision and credible strategy to deliver high quality care and support. Staff were aware and involved in this vision and the values shared.

Further information is in the detailed findings below

Inspection carried out on 23 and 24 September 2015

During a routine inspection

This inspection visit took place on 23 and 24 September 2015 and was announced.

At the last inspection on 16 September 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Blackpool North, Cleveleys and Fleetwood Home Instead is a privately owned domiciliary agency situated on Red Bank road, Bispham. The agency provides a wide range of services including personal care, companionship, medication support, meal preparation and light housekeeping. The agency’s office is located on the second floor and cannot be accessed easily by people with mobility problems.

At the time of our inspection visit Blackpool North, Cleveleys and Fleetwood Home Instead provided services to 28 people.

There was a registered manager in place. 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.

People told us they had been visited by the registered manager before their support began and had an assessment of their needs undertaken. One person we spoke with said, “The whole procedure was very thorough. Their philosophy is to match you with staff you will get on with. This has worked very well for me.”

We spoke with seven people who were supported by the service. They told us they were receiving a reliable and consistent service and they liked the staff who supported them. They said staff were caring and conscientious and they felt safe when receiving their support. One person we spoke with said, “I have no concerns about my safety. I am receiving the best care possible.”

People told us they were supported by the same group staff who understood their support needs and how they wanted this to be delivered. They told us the staff who visited them were professional caring people and they looked forward to their visits.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks, telephone monitoring and care reviews. We found people were satisfied with the service they were receiving. The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

Inspection carried out on 16 September 2014

During a routine inspection

During this inspection the Inspector gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? During the inspection we looked at the services quality monitoring procedures, care and staff recruitment records and procedures the service had in place to safeguard people from unsafe practices. The Inspector also gathered information from people using the service by telephoning them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity were respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

We found recruitment practices were safe and thorough. This ensured people working for the agency were fit to work with vulnerable people.

Is the service effective?

People’s health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person.

Is the service caring?

We spoke with people being supported by the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive. One person we spoke with said, “The service we are receiving is fantastic and is much better than I expected. I feel very lucky to have found them.” Another person said, “I really can’t complain about anything. They meet all my needs and I really like my carer.” The relative of one person said, “I am happy with the service being provided. The support we are receiving has more than matched my expectations.”

People using the service and their relatives had completed satisfaction surveys. Where shortfalls or concerns had been raised these were taken on board and dealt with. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People being supported told us the agency was providing a reliable, flexible service which was meeting their needs. They said the agency was well run, provided good value for money. One person said, "My carer is very reliable. The company looks after her and she looks after me. Things are running very smoothly. They are the best agency that has supported me.” Another person said, “I have found them to be a reliable service. I always have the same carer and I look forward to her visits.”

People knew how to make a complaint if they were unhappy. One person said, “I am happy with the service I am receiving and have no complaints.” The people we spoke with confirmed they had a copy of the agency’s complaints procedure. They told us they knew how to make a complaint if they were dissatisfied with anything. They said they were confident they would receive an appropriate response if they had any concerns about their service.

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.