Background to this inspection
Updated
23 April 2016
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.’
The inspection was carried out by one inspector.
We reviewed all the information we had available about the service including notifications sent to us by the manager. This is information about important events which the provider is required to send to us by law. We also looked at information sent to us from other sources. We used this information to plan our inspection.
This was an announced which inspection took place on 20 and 25 January 2016. We gave the service 48hours notice that we were coming to inspect. This was to give time for the service staff to make arrangements with and gain their consent that we could visit them in their own home. We visited five people in their homes and we spoke with a further twelve people using the service and three relatives on the telephone. We spoke with the care delivery director, the manager and six members of care staff.
We looked at the care plans of the five people we had visited and compared these with the records held in the office. We also looked at a further three care plans and records relating to the management of the service including four staff files, supervision, annual appraisal and staff training records. We also looked at audits and surveys to determine if people using the service were satisfied.
Updated
23 April 2016
This was an announced inspection which took place between 20 and 25 January 2016.
The service is registered to provide personal care to people who live in their own home.
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.
The manager organised staff to carry out assessments to see if the service could meet people’s needs. Careful consideration had been given to determine if the service had sufficient staff to meet individual’s needs with regard to the location of where people lived. This branch of the service had taken over the work of a recently closed branch in Clare. An active and robust recruitment campaign for new staff had been embarked upon to ensure sufficient staff were available to attend to people’s assessed needs.
An assessment of people’s needs was carried out prior to the service providing care. This included risks to the individual receiving care and environmental risks. We saw that risks reviews for people were in place and reflected the current situation.
The provider had a safeguarding policy for staff that gave guidance on the identification and reporting of suspected abuse. Staff we spoke with were aware of how to raise and concerns regarding suspected abuse because of the training that had been provided.
There were sufficient staff to support people safely and provide care. Some people told us that the service staff did not miss their call, but were sometimes late. That is they came over half an hour past the allocated time. People we spoke with told us that this had improved recently. Some people had also found that when they wanted to change the time of their visit for one day, to attend an appointment. The service was not always able to accommodate this change. When the service staff were running late or in danger of missing calls to provide care to people, the service had back-up plans in place to deliver the care to people. We were also told that the service tried to ensure that when a person specified the gender of the staff member to care for them, the service usually was able to accommodate the request. If it could not then service staff did inform people in advance. The service had been able to recruit more staff in the past few months and hence was in a better position to provide the gender of staff of people’s choice and also to arrange visits within the allocated time.
All people we spoke with had a care plan and they considered it was accurate. We saw that the plans were organised into a structure which identified what the staff were required to do at each visit. We also saw that at each visit the staff had written in the notes what had been achieved. The plans were person-centred and emphasis had been placed upon how to address the person and who to contact in an emergency. The service had undertaken a considerable piece of work to introduce a new care plan format in April 2015. The individual’s care plans were reviewed as required to ensure they reflected the needs of the person.
Training records informed us staff had received training to provide medication safely and the service had medication procedures in place which had been reviewed. The service had an equipped training facility and staff had received training in mental capacity and various subjects so that they could provide support to people with regard to their needs such as diabetes.
People and their relatives gave positive feedback about the staff that provided care. The service provided supervision and spot checks to support the staff. The service had policies and procedures in a place and staff told us that they had been given time at their induction for important information to be explained to them. Staff we spoke with considered they were well supported especially as they could raise matters as they happened with the service senior staff.
People and their relatives told us they were involved in the planning of their care and support. They felt that the service listened to their views. They told us that when they contacted the service their calls were always answered and staff tried to support and help them. At the time of our inspection the service informed us there were no outstanding complaints.
The service had systems in place to monitor the quality of service and had worked with people using the service and members of staff when improvements had been identified for them to be implemented. There was an on-call service available for staff and people using the service to contact to request support or raise a matter of concern.