Archived: At Home With You

This inspection was announced and took place on 06 June 2018. We gave the provider 48 hours’ notice of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

At Home with You is registered to provide personal care to people living in their own homes. There was a registered manager in place who is also the registered provider. 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 inspection nine people received care and support services.

People told us they felt safe with the support of staff but staff frequently did not arrive for calls at the agreed time and this could leave people waiting for care or not knowing if staff were coming. People told us they received their medicines as required and staff said they had received medication training to support people appropriately.

People received care from staff that understood how to keep them safe and minimise the risk of potential harm.

The provider did not consistently complete appropriate employment checks to ensure staff were suitable to deliver care and support before they started work.

People told us regular staff knew them well and had the skills and knowledge to meet their needs. Staff told us they received the right training for the people they supported.

People said staff supported them by preparing a choice of meals and drinks to support their wellbeing. Staff understood they could only care for and support people who consented to being cared for.

People told us that although individual staff were caring they felt the service was not caring because calls were not made on time and they were not always informed in advance. Staff treated people with privacy and dignity and respected people’s homes and belongings.

People told us they felt happy to raise any concerns with staff and when they had raised concerns action had been taken in response. The registered provider had a system in place to deal with any written complaints.

Governance systems and processes to monitor and improve the quality of care people received were not robust in identifying areas requiring improvement and ensuring that action was taken in a timely way.

Staff said the management team were available to them and provided advice and guidance when required.

You can see what actions we told the provider to take at the back of the full version of this report.

The service is a domiciliary care service that provides personal care to people in their own homes. At the time of our inspection, there were 21 people using the service. There was a registered manager in place. 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 and relatives who used the service told us they felt safe. Staff had received safeguarding training and understood the need to share concerns with the registered manager.

People’s risks were managed by staff, however risks associated with people’s care needs were not always appropriately identified and plans put in place to ensure that they were always protected from unnecessary risk.

Most people received their calls on time, however systems had not addressed occasions where calls had not been attended in a timely way. People were not always protected by robust recruitment processes.

There were not effective systems in place to ensure that people always received their medicines safely where they required this support.

Most staff we spoke with felt supported and received training for their roles, however methods to assess competency and improve staff performance were not routinely undertaken. People were not consistently supported to make their own decisions and staff had not received clear guidance and training to ensure they upheld people’s rights.

Some people were supported by staff to prepare and have meals and drinks. However staff did not always complete daily care records where required so that the details of people eating and drinking enough to remain well could be monitored.

People were supported by caring staff. Staff members we spoke with provided examples of how they treated people with dignity and respect. People were supported to access the support of healthcare professionals where required.

People received care that was responsive to their needs. People and relatives had been involved in care planning and reviews, however these were not always undertaken in a timely way.

People’s care plans included some personal details and instructions for their routines and support needs. Care plans lacked information to guide staff about people’s health conditions and associated risks and did not always reflect people’s changing needs.

People and relatives were asked for their feedback on the quality of the service and were comfortable with raising concerns. Feedback and concerns were not always managed and addressed effectively.

People, relatives and staff mostly gave positive feedback about the running of the service. The provider had some systems in place for assessing and monitoring the quality of the service provided. These systems were not always sufficient to ensure that people received a consistently good quality service and ongoing improvements were made to the quality of the service.

You can see what action we told the provider to take at the back of the full version of the report.