2 June 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 checked 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 announced inspection was completed by one inspector and took place on 26 April 2018. We gave the service 48 hours’ notice of the inspection visit because it provides a domiciliary care service and we needed to be sure someone would be there to facilitate our inspection.
Before the inspection we reviewed information we held about the service and contacted the local authority and local healthwatch to obtain their feedback of the service. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also sent out 50 questionnaires to people and their relatives and received 16 responses telling us of people’s experiences.
During the inspection we spoke with twelve people over the telephone. We spoke with three care staff, the care manager and the two registered managers. We looked at 10 care records and eight staff files including recruitment, induction and supervision records. We reviewed feedback from people and their relatives about how the service was run. We reviewed policies, complaints logs, telephone monitoring logs, supervision and spot-check records. We also looked at 10 medicine administration records.
2 June 2018
This announced inspection took place on 26 April 2018. At our previous inspection on 22 March 2016 the service was rated Good with a breach relating to notifications and monitoring systems. At this inspection we found the service had improved and the overall rating remained Good.
This service is 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. On the day of our inspection there were 160 people using the service in the London boroughs of Havering and Essex.
On the day of our visit we met the two registered managers. 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.
Medicines were administered safely with the exception of the recording of topical creams and medicines in blister packs. We recommended that best practice guidelines were followed.
People told us they were happy with the care they received. They told us they were treated with dignity and respect by staff who were polite and kind.
Staff were aware of the safeguarding guidelines in place and knew the steps to take to record any abuse.
Risks to people were assessed with clear actions to take to reduce the identified risks. These were known and understood by staff.
Infection control guidelines were followed in order to keep people clean and minimise the spread of infection.
People told us there were enough staff to meet their needs which was confirmed in the rotas and records we reviewed.
There were robust recruitment checks in place, which ensured only staff that had been assessed as suitable to work with vulnerable people were employed. Staff were supported by regular spot checks, supervisions and annual appraisal. They attended training in various subjects in order to perform their roles effectively.
People were supported to maintain a balanced diet that met their individual preferences. They were supported to access healthcare services in order to enable them to maintain their health.
Most care plans were person centred and were reviewed regularly together with people and their relatives. We made a recommendation to ensure all aspects of care plans were person centred as aspects such as food preferences and daily routines were not always included.
There was an effective complaints process, which was understood by people and staff. People told us they were able to raise concerns and that the management followed up any concerns with the aim to resolve them satisfactorily.
People and their relatives and staff thought the service was managed well and that there was always someone available over the phone whenever they needed assistance.
The quality of care delivered was monitored through audits spot checks and surveys and action was taken to ensure people’s views were listened to.