Quality Care @ Home

Quality Care @ Home is a domiciliary care service that provides personal care and support to people in their own homes. The service is registered to provide support to younger adults and older people, living with dementia, mental health support needs, physical disabilities and sensory impairments. At the time of our inspection 64 people were using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Since our last inspection the provider had further developed their systems for the management of medicines and their processes and systems to ensure relevant agencies were notified of any significant events.

People were protected from the risk of abuse by staff who had a good understanding of how to keep people safe. Staff recognised the signs of abuse and how to report it.

Risks to people's health had been identified, assessed and monitored. Staff were knowledgeable and knew the risks to people and helped make sure they stayed safe.

Recruitment was undertaken safely, with appropriate background checks before staff started work.

There was sufficient supplies of PPE and people and their relatives confirmed staff wore this. Staff had received appropriate training in infection control.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by a staff team that were kind and compassionate with whom they had developed positive relationships.

People and staff told us the service was well led and managed. Staff told us they felt supported, the team worked well together, and staff morale was good. The provider had systems in place to identify improvements and drive good care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 17 June 2019). The provider showed us what action they had taken after the last inspection to show how they had improved. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 18.

Why we inspected

We undertook this focused inspection to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Quality Care @ Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Quality Care @ Home is a domiciliary care service that provides personal care to people in their own homes. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, 73 people were using the service.

People's experience of using this service:

People’s medicines records were not always completed in line with good practice guidelines. The provider had not always informed CQC about safeguarding issues involving the people who used the service, in accordance with their registration with us. Although prospective staff underwent pre-employment checks, these did not include a review of any gaps in their employment. The provider needed to improve the effectiveness of their quality assurance systems and processes.

People were protected from harm and abuse by staff who received training and support from the provider to enable them to work safely. People received a consistent and reliable service from the provider. Risks associated with people’s individual care needs were assessed and plans put in place to manage these. The provider took steps to protect people, staff and others from the risk of infections.

New staff received an effective induction to help them understand and settle into their new roles. People's needs and wishes were assessed before their care started and then kept under regular review. The provider worked proactively with a range of community health and social care professionals to achieve positive outcomes for people. Staff sought people's permission before carrying out their care and supported their decision-making.

Staff approached their work with kindness and compassion, and treated people with dignity and respect. The provider encouraged people and their relatives to share their views on the service, and listened to these.

People's care and support was adjusted to their individual needs and requirements. Staff read and followed people’s care plans. People and their relatives knew how to raise any concerns or complaints with the provider.

The provider promoted a positive and inclusive culture within the service, based upon open communication with others and respect for their views. Staff felt valued, well-supported and were clear what was expected on them at work. The provider sought to involve people, their relatives and staff in the service.

We found the service met the requirements for ‘Requires Improvement’ in two areas, and 'Good' in the remaining three areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

At the last comprehensive inspection, the service was rated ‘Good’ (inspection published on 12 November 2016). At this inspection, the overall rating of the service was ‘Requires Improvement’.

Why we inspected:

This was a planned inspection based on the service's previous rating.

Enforcement:

We have identified a breach in relation to the provider's failure to tell us about two safeguarding issues involving the people who used the service.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any information of concern is received, we may inspect sooner.

Quality Care@ Home is registered to provide personal care and support for people in their own homes. At the time of our inspection 60 people received care and support from this service.

There was a registered manager 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 felt staff provided support in a safe and caring way. Staff understood how to recognise and protect people from abuse and received regular training around how to keep people safe. Staff were not recruited until checks had been made to make sure they were suitable to work with the people that used the service.

People were supported by staff and management that were approachable and listened to any concerns that people or relatives had.

Staff were reliable and there were enough staff to meet people’s needs.

People were confident that staff had the knowledge, skills and experience to provide the right care and support. People’s care records contained the relevant information for staff to follow to meet people’s health needs and manage risks appropriately. Care plans and risk assessments were clear and updated quickly if people’s needs changed.

People were involved in the care and support that they received. People told us they had choice over the support they received and nothing was done without their consent. Staff understood the principles of consent and delivering care that was individual to the person.

Staff responded quickly if someone was unwell and supported people to access other health professionals when needed. People were supported to take their medicine safely and when they needed it.

The provider and registered manager had systems to measure the safety and quality of the service. Checks and audits were completed regularly to make sure that good standards of care were maintained.