Background to this inspection
Updated
20 September 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.
Before the inspection, we reviewed all the information we held about the provider. This included information shared with us from the Local Authority and statutory notifications received from the provider. A statutory notification is information about important events which the provider is required to send to us by law.
We did not ask the provider to complete a Provider Information Return (PIR) prior to this inspection. The PIR 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. We did not request this form because the inspection date was brought forward in response to information we had received about the service.
The office visit took place on 1 August 2016 and was announced. We gave the provider 48 hours’ notice we would be coming so they could ensure they would be available to speak with us and arrange for us to speak with staff. The inspection was conducted by two inspectors 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.
Before the office visit we spoke with 21 people or their relatives by telephone. During our visit we spoke with five care staff, the registered person and office based staff. The office based staff included the care co-ordinators for South and East, head of senior care staff, a senior care staff member and a staff member responsible for recruitment and training.
We reviewed four people's care plans to see how their care and support was planned and delivered. We checked whether staff had been recruited safely and were trained to deliver the care and support people required. We looked at other records related to people's care and how the service operated including the services’ quality assurance audits.
Updated
20 September 2016
Swift House is a domiciliary care agency which provides personal care support to people in their own homes. At the time of our visit the agency supported around 150 people with personal care.
We visited the offices of Swift House on 1 August 2016. We told the provider we were coming before the visit so they could arrange for staff to be available to talk with us about the service. There was a management team based in the office that organised the scheduling of calls, staff training and recruitment.
The service has a registered manager but at the time of our visit they were on a period of extended leave. 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. At the time of our visit the assistant manager/finance manager who was also the registered ‘nominated individual’ for Swift House was managing the home. They are referred to in this report as the ‘registered person.’
People felt safe using the service and care staff understood their responsibilities to protect people from abuse and keep people safe. There were procedures to manage identified risks with people's care although there were some risk assessments that had not been developed, which the registered person agreed to address. People told us they received their medicines as required.
Recruitment checks were carried out for new staff to make sure they were suitable to work with people who used the service. There were enough staff to deliver the care and support people required and most people were positive about the staff. They said staff had the right skills to provide the care and support they required and they stayed long enough to complete the care they required.
The provider and registered person understood the principles of the Mental Capacity Act (MCA). Care staff were to complete training to develop an increased knowledge and understanding of the MCA. Care staff knew to gain people's consent before they provided personal care.
Staff received an induction when they started working for the service and completed training to support them in meeting people's needs safely and effectively.
Care plans contained information for staff to help them provide the personalised care people required. People knew how to complain and said that the management team based in the office were helpful in resolving concerns. Care staff said they could raise any concerns or issues with the management team knowing they would be listened to and acted on.
We found that whilst staff were responsive to people’s needs, some people experienced calls outside of their agreed times and received support from an inconsistent group of care staff.
There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. However, we could not always see that information collected resulted in lessons being learned and improvements to the service.
Audit processes did not consistently identify that records were not always up-to-date and accurate. This included the Statement of Purpose and complaints records. We also found that sometimes actions were not identified and addressed. This included reporting safeguarding information to us as required.
Staff felt supported by the provider and the management team and most were positive about their experiences of working for Swift House.