Background to this inspection
Updated
10 August 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 took place on the 12 July and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.
The inspection team consisted of one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
On this occasion we did not ask 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.
Before the inspection we checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law. We used all this information to decide which areas to focus on during our inspection.
During our inspection we spoke with one person who uses the service and seven relatives on the telephone, four care staff, a registered nurse, two branch consultants and the registered manager. We observed the registered manager and staff working in the office dealing with issues and speaking with people who used the service over the telephone.
We reviewed a range of records about people’s care and how the service was managed. These included the care records for six people, medicine administration record (MAR) sheets, six staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.
We contacted one health care professional after the inspection to gain their views of the service.
This was the first inspection of the service since being registered.
Updated
10 August 2016
The inspection took place on the 12 June 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.
Interserve Healthcare Brighton provides domiciliary care and support for people in their own home. The service provides personal care, help, and support to people with a variety of needs. Care services are delivered to adults, children and young people with varying conditions including spinal injuries, acquired brain injuries, learning disabilities and mental health requirements. At the time of our inspection 23 people were receiving a service, which of 7 adults and 11 children were receiving the regulated activity of personal care.
The service 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.
The experiences of people were positive. People and relatives told us they felt safe using the service, that staff were kind and the care they received was good. Comments included “We are really satisfied that our relative is in safe hands, otherwise we couldn’t leave him with his carer” and “They are a life saver, you can’t fault them. I have such a complex condition and I know that I am at risk if I am without care. I feel safe with them and have a fantastic rapport I have built up over the years”.
There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.
The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access health care services when needed.
The service considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.
Staff felt fully supported by the registered manager to undertake their roles. They were given training updates, supervision and development opportunities. For example, staff were offered to undertake additional training and development courses to increase their understanding of the needs of people using the service. One member of staff told us “The training is very good, and we get many updates each year to ensure we are up to date”. On speaking with staff we found them to be knowledgeable and skilled in their role.
People and relatives told us that staff were kind and caring. Comments included “The care I get is amazing, in fact I put one of my carers through to carer of the month this month. That’s how brilliant she is” and “You can’t actually fault the care. The quality of the caring and nursing staff is extremely high and the only problem is that there is not enough of them”
People and relatives confirmed staff respected their privacy and dignity. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People were supported at mealtimes to access food and drink of their choice.
The registered manager monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by the registered manager through surveys which were sent to people and their relatives. Survey results were positive and any issues identified acted upon. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues.
People and relatives said they were happy with the management of the service. Where there had been a recent registered manager change, people were pleased with the new registered manager where they may have experienced problems in the past. One person told us “The ones they do have [staff] are brilliant but lately there have been some short cuts and standards have slipped. It’s particularly noticeable when they changed the manager earlier in the year, the training just wasn’t there. That person is no longer with the agency and the new manager seems to getting things back on track”.