Archived: St Elizabeth's Domiciliary Care Agency

There was a registered manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 were supported by St Elizabeth’s to live in their own homes.

People felt safe, happy and were looked after in their homes. Staff had received training on how to safeguard people from the risk of abuse and knew how to report concerns both internally and externally. Safe and effective recruitment practices were followed to help ensure that all staff were suitably qualified and experienced.

Staff completed regular health and safety checks that included security and fire safety.

Relatives and healthcare professionals were positive about the skills, experience and abilities of staff who worked in people’s homes. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. People were supported to eat a healthy and varied diet.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people access independent advice if required.

Staff had developed positive and caring relationships with the people they supported and clearly knew them well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained in the office.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at their home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives and staff were complimentary about the registered manager and how the service was run and operated. Appropriate steps were taken to monitor the quality of services provided, reduce potential risks and drive improvement.

We spoke with five people who used the service and two senior lead staff. We also spoke with four care staff and looked at four people's care records. Other records viewed included health and safety records, policies and procedures, complaints and satisfaction questionnaires completed by the people who used the service.

During our inspection and during the analysis of our inspection findings we considered the questions we always ask; is the service safe, is the service effective, is the service caring, is the service responsive and is the service well led?

This is a summary of what we found;

Is the service safe?

We saw that risk assessments had been completed so that risks associated with people's care and support could be minimised.

We examined medication records, how it was stored and observed the way medication was administered to people. We found that the medication was managed and administered in a way that protected the health and wellbeing of the people who used the service.

Is the service effective?

People told us that they were happy with the service and that their needs were met. One person said, "I'm looked after OK."

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

The service co-operated well with other providers to support people when they joined the service and when they finished college and were moving on.

Is the service caring?

People told us that the care staff and managers listened to them. One person said, "They (the staff) are nice people." Another person said, "They (the staff) help me."

The staff we observed showed a good understanding of people's needs and demonstrated that they had built up good relationships with the people they supported.

Is the service responsive?

People told us that the service listened to what they had to say and acted on what they said. One person said, "They (the service) are going to help me find somewhere to live, exactly what I want." Another person said, "They (the staff) help me do what I need."

Records showed that the provider had worked with the speech and language team, occupational therapist and GPs to ensure people's wellbeing.

People using the service completed satisfaction questionnaires. Where shortfalls or concerns were raised these were addressed.

Is the service well-led?

The service had effective quality assurance systems in place and records showed that they identified shortfalls and acted to address them with the expectation that the quality of the service would continue to improve.

The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say.

The records we looked at were complete, well ordered and were stored securely. Any records we asked to see were produced quickly.

We checked the medication held for three people. For two of the three people whose medicines were checked, we found discrepancies between the records of how much medicine was in stock and the actual amount held. We saw that in two out of the three rooms we checked in which medication was stored the recommended temperature for the storage of medication had been exceeded for lengthy periods in both summer and winter months.

We saw that there had been references obtained from previous employers for all of the new staff members and that appropriate checks had been completed before they had started work.

We saw that the records for each person included a copy of the services complaints leaflet in easy to read format which advised people that they could get someone to assist them to make a complaint or a 'grumble'. People were told that they should receive a response to a 'grumble' within five days of it being made and we saw that this happened.

Care plans were up to date, signed by people and two people we spoke with confirmed that they were involved in care planning.

We saw that staff prompted and guided people in what they did and respected their independence and abilities.

Staff told us that they were well supported to help people learn while their learning and independence were promoted. Staff were seen respecting people's dignity and privacy throughout our visit on 14 November 2012.

People felt safe and were involved in monitoring the quality of the service. Results from the quality monitoring process, held jointly by the agency and the College showed continued progress year after year in people's satisfaction.