Archived: Bespoke Care At home

The registered manager has been in post since December 2015. 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 and their relatives felt staff were caring, respectful and listened to what they had to say. This was observed during our visit to one person’s home. People were involved in decisions in regards to their care; exercised choice and were encouraged to maintain their independence. Staff ensured people’s dignity was respected when carrying out personal care. People said this was carried out in a dignified way. Staff had developed good working relationships with the people they provided care and support to. Care records evidenced staff were aware of what was important to people. This included their social histories; hobbies and their preferences.

People felt safe with the care provided and knew what to do if they had concerns. Staff had attended relevant training and demonstrated a good understanding of how to keep people safe from abuse. Risk management plans were put in place when risks were identified. These clearly outlined what staff needed to do to minimise the risks. The service ensured staff administered medicines safely. Training records showed staff had attended relevant training and people said the support they received with their medicines was appropriate. The service carried out safe recruitment practices which ensured people were cared for by staff who were of good character. We observed there was sufficient staff to provide care and support to people; this was supported by our review of staff rosters.

People received care and support from staff who received appropriate induction; training; supervision and appraisal. This was supported by our reviews of staff records and what people had told us. Staff demonstrated a good understanding of how to work with people who were unable to make specific decisions. However, we noted mental capacity assessments were not undertaken when people were not able to make specific decisions. We have made a recommendation for the service to seek current guidance on how to carry out mental capacity assessments in line with the Mental Capacity Act 2005 (MCA).

People said staff asked for their consent before care was delivered, a review of their care records supported this. People were effectively supported to eat well balanced meals and received support from the service to access other health professionals.

People felt the care delivered was specific to their individual needs. Initial assessments ensured the service captured essential information about people in order to establish what their care and support needs were. People said staff were responsive to their needs and review of care meetings enabled them to communicate if changes in care their care and support needs was required. Care plans and risk assessment were regularly reviewed for their effectiveness and where there were changes in people’s care and support needs, these were clearly recorded in people’s care records.

People and their relatives knew how to raise concerns and the complaints log evidenced all complaints received were responded to in line with the service’s complaint policy and procedure.

People and their relatives felt the service was well managed. Staff felt supported and said they were kept up to date with changes, able to provide feedback to management and due to this, changes to work practices had been made. The service sought feedback from people using various methods such as unannounced spot checks and weekly telephone calls. This enabled the service to make necessary changes to people’s care needs and current work practices where required.

The service had effective quality assurance systems in place to improve the quality and safety of people who used the service. These were regularly monitored and reviewed for their effectiveness.