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Inspection Summary


Overall summary & rating

Good

Updated 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.

Inspection areas

Safe

Requires improvement

Updated 13 October 2018

The service was not consistently safe.

Staff recruitment was not performed consistently and did not ensure staff were safe to work with people.

People felt safe at the service. Risks associated with the delivery of people's care and support had been adequately assessed and planned for.

There were sufficient numbers of trained and skilled staff working at the service.

Medicines were safely administered, and people were protected from the risk of infection.

Incidents were being responded to, to ensure people's safety.

Effective

Good

Updated 13 October 2018

The service remained effective.

Caring

Good

Updated 13 October 2018

The service remained caring.

Responsive

Good

Updated 13 October 2018

The service was responsive.

People received care that met their needs and had plans of care that were updated as their needs changed.

People and their relatives had information on how to make complaints.

People were supported to plan and make choices about their care at their end of life.

Well-led

Good

Updated 13 October 2018

The service was well-led.

There was a visible and compassionate leadership at the service, with a clear vision to provide good quality care.

Systems were in place to monitor the quality of care and support people received and care plans and risk assessments were regularly updated.

People and staff were engaged to suggest changes and improvements to the service.