Background to this inspection
Updated
22 November 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 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 site visit took place on 15 October and continued 16 October 2018 and was announced. The provider was given 48 hours' notice. This was so we could be sure a manager or senior person was available when we visited. The inspection was carried out by one inspector and an expert by experience. They had experience of supporting older people.
Before the inspection we reviewed all the information we held about the service. This included notifications they had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.
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 some key information about the service, what the service does well and improvements they plan to make.
We spoke with 20 people who used the service, four in their own homes and 16 on the telephone. We spoke to three relatives, one health and social care professional, two senior care staff and five care staff.
We spoke with the registered manager, operations manager, care coordinator and a community team manager. We reviewed six people's care files, three medicine administration records, policies, risk assessments, health and safety records, consent to care and quality audits. We looked at four staff files, the recruitment process, complaints, training and supervision records.
Updated
22 November 2018
The inspection took place on 15 and 16 September 2018 and was announced.
Candlelight Homecare Services Sherborne is a domiciliary care agency. At the time of the inspection it was providing personal care to 71 people living in their own houses and flats in the community. It provides a service to older people and younger adults some of whom have a physical disability, learning disability, sensory impairment or dementia.
Not everyone using Candlelight Care Sherborne receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided
The service had a newly appointed 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 and associated Regulations about how the service is run.
People received their care and support at their agreed time, and received rota’s letting them know who would be visiting them. They told us that they were supported by familiar staff, who they had got to know and saw regularly. At the time of the inspection staff told us they were working additional hours to support a number of vacant hours.
There was a risk that people may not always be supported by suitable staff in their own homes as full employment checks had not always taken place. Some staff were allowed to start work by shadowing more senior staff before references and disclosure and barring [DBS] information had been received. The provider took action to reduce the risk immediately following the inspection.
People told us they were supported by familiar staff, and staff arrived on time. The provider told us although they were currently understaffed they had ensured all people receiving a service did so with the correct amount of staff and on time. People confirmed they had not had any late calls.
People received a kind and caring approach to their support needs and told us they would recommend the service. One relative said, “The staff are a great support. They really do encourage [ relative] to do as much as they can for themselves. I would recommend this service any day.”
Initial assessments were completed with people to establish whether the service would be able to meet their presenting needs. From the initial assessment a care plan was drawn up. People told us they had been involved in their assessments and received regular review of their care and support.
Risk assessments were monitored to keep people safe whilst promoting people’s independence and rights to make their own decisions. General environmental risks to people were assessed such as fire safety and home security. People also had personalised risk assessments to reduce risks associated with things such as their skin integrity, medicines and health conditions or dementia.
People were supported by staff who had received safeguarding training and knew how to keep people safe from harm or abuse. People were supported to understand what keeping safe meant. Staff told us they reported any accident and used body maps to identify where any injuries had occurred. The registered manager told us accidents and incidents was analysed to establish any trends.
People received their medicines on time and as prescribed. Staff understood the importance of infection prevention and control, and wore protective equipment appropriately when supporting people. Any medicine errors were reported and lessons learnt, and additional training provided if needed.
People felt the service listened to them and made changes to support their requests. A complaints process was in place and people told us they would be happy to raise a complaint if they needed to. We observed complaints had been resolved in line with the providers policy. People we spoke with were very complimentary about the service and felt it was well led. Staff felt included and encouraged to contribute their views and ideas.
The service worked alongside other providers in the local area, and understood the importance and benefits to people of working closely with health professionals and did this to help maintain people’s health and well-being. The registered manager told us they had established and maintained good working relationships with district nurses, GPs, district nurses, and social work teams.
There were quality assurance and auditing processes in place and they contributed to service improvements. Action plans were carried out and those responsible kept things up to date.
The service understood their legal responsibilities for reporting and sharing information with other services.