Background to this inspection
Updated
19 December 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.
The inspection site visit took place on 21 November 2018. We gave the registered manager 48 hours’ notice of the inspection because it is a small service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
The inspection site visit was carried out by one inspector.
We looked at the providers Statement of Purpose. This is a document providing information as to the aims and objectives of the service, the support and services it provides and to who.
We looked at the information held about the provider and the service including statutory notifications and enquiries relating to the service. Statutory notifications include information about important events which the provider is required to send us. We also contacted the Local Authority for any information they held on the service. We used this information to help us plan this inspection.
We spoke with two family members by telephone on 22 November 2018.
We spoke with the registered person and the registered manager when we visited the office on 21 November 2018. We spoke with three members of staff by telephone on 22 November 2018.
We looked at the care plans and records of two people. We looked at two staff records, which included their recruitment, induction, on-going monitoring and training. We looked at the minutes of staff meetings and records related to the quality monitoring of the service.
Updated
19 December 2018
The announced inspection site visit took place on 21 November 2018. Grace Integrated Care Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was providing support for three people residing in Northamptonshire. People's care was provided by the nominated individual, the registered manager and five members of staff.
Grace Integrated Care Limited had a registered manager. 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.
Grace Integrated Care Limited was previously inspected by the Care Quality Commission on 27 September 2017 and the report published on 31October 2017. We found three breaches of the regulations. The overall rating for the service was requires improvement.
Following the last inspection of 27 September 2017, we asked the provider to complete an action plan to show what they would do and by when to improve medicine systems and processes, ensure staff recruitment was robust and to ensure effective governance of the service. We found improvements had been made.
People’s records provided information as to the medicine they were prescribed and who was responsible for its administration, such as family members or staff. We found staff were responsible for applying prescribed creams and and this was recorded within people’s records.
Staff recruitment records evidenced necessary pre-employment checks had been carried out prior to the commencement of their employment.
Systems to monitor the quality of the service were found to be effective. Where shortfalls were noted by the registered manager action was taken by them to bring about improvement. The action taken was recorded and communicated with staff.
This inspection has found the service has improved its overall rating from requires improvement to good.
People’s safety was promoted by staff who implemented the guidance as detailed within people’s risk assessments and care plans. Staff were knowledgeable about people’s care and support and the importance of using equipment to support in the delivery of care safely. Family members spoke positively about the consistency of a small team of staff in the provision of care, which meant their relatives were comfortable and relaxed when personal care was delivered.
People’s needs were assessed to ensure the service and staff could meet their needs. We found, people were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible; the policies and systems in the service supported this practice.
Staff received support from the registered manager, through supervision and checks to ensure they were competent to carry out their roles effectively. Staff received the training they needed to provide safe and effective care to people.
Family members spoke of the positive relationships they had developed with staff. People’s dignity and privacy was promoted and people were aware of how confidential information would be stored and the circumstances in which it would be shared.
People’s views and those of their family members had been sought to develop their care plans, which were regularly reviewed by the registered manager. People’s care plans had considered the individual needs of each person and the role of staff in meeting these. Concerns had been investigated and documents supported this, which included the action taken to address the issues raised.
Systems were in place to monitor the quality of the care being provided, which included seeking the views of those using the service and family members. A range of audits were undertaken to evidence the quality of the care and the accuracy of records used to record people’s care and support. There was an open and transparent approach to the management of the service, which included team meetings, supervision and competency assessments of staff.