13 October 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 visit was carried out by one inspector and took place on 16 August and 3 September 2018 and was announced. We gave the service 48 hours’ notice of the inspection because we needed to be sure that a manager would be in to help us. On the first day we visited the care office and on the second day spoke with people's relatives whose relations used the service.
Before the inspection, we asked the provider to complete 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. This was returned to us by the provider and used to inform our judgement.
We reviewed the information we held about the service. This included statutory notifications regarding important events which the provider must tell us.
During the inspection we spoke with three relatives of people who used the service. We spoke with three staff who provided care and support to people, a care coordinator, the registered manager and the provider.
We looked at the care records of three people who used the service. These records included care plans, risk assessments and daily records of the support provided. We looked at three staff recruitment files and staff training records. We looked at records related to how the quality of the service was monitored. We also had some documents sent to us following the inspection. These included quality audits and checks, minutes of meetings, and feedback provided by people who used the service and their families.
13 October 2018
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service provides care and support to adults with a range of needs.
This inspection took place on 16 August and 3 September 2018 and was announced. The first day we visited the office and looked at paperwork. The second day we called and spoke with people who used the service and staff.
At our last inspection in 5 December 2017 we rated the service overall as ‘Requires Improvement’. Improvements were needed in the information in care plans and the embedding of periodic audits. At this inspection the service had improved, we found evidence to support the rating of Good.
A registered manager is in post. 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.
People were not protected by safe recruitment process which failed to ensure staff were suitable to work in care services, though improvements were made before the inspection was completed. There were enough staff to meet people's needs. Staff received training for their role and ongoing support and supervision to work effectively.
People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed, and preventative action was taken to reduce the risk of harm to people.
People were supported with their medicines in a safe way. People’s nutritional needs were met, and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's consent was obtained before they were supported.
People were involved in their care as far as possible and care plans were regularly reviewed and updated as people’s needs changed. Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences, and worked flexibly to ensure they were responsive.
People’s relatives were happy with staff who provided their relations personal care needs and all had developed positive trusting relationships.
People and their relatives were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to.
The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.
The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. Lessons were learnt when things went wrong, and improvements made to prevent it happening again. The provider worked in partnership with other agencies to meet people’s needs and people's health and well-being was continuously monitored at the service.