12 September 2018
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 registered provider was 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.
This comprehensive inspection was carried out by an adult social care inspector and included a visit to the agency’s office on 26 July 2018. To make sure key staff were available to assist in the inspection the registered provider was given short notice of the visit, in line with our current methodology for inspecting domiciliary care agencies. An inspection assistant contacted 14 people and three relatives on 27 July 2018 for their views of the service.
To help us to plan and identify areas to focus on in the inspection we considered all the information we held about the service. Before the inspection, the provider had also completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We requested the views of other agencies that worked with the service, such as service commissioners, healthcare professionals, social workers and Healthwatch North Lincolnshire, by email, telephone or using questionnaires. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We spoke with the registered manager, nominated individual and 10 staff; this included, team leaders, senior rehabilitation officers and rehabilitation officers, workers and assistants. We also considered the outcome of 20 questionnaires returned to us by staff, 16 from people who used the service and five from relatives.
We looked at documentation relating to people who used the service, staff and the management of the service. This included five people’s care records and medication administration records, three staff recruitment files, training and support documentation. We also looked at how the agency gained people’s views on the service provided, as well as checks made to ensure company policies were being followed.
12 September 2018
This inspection took place on the 26 and 27 July 2018 and was announced.
North Lincolnshire Council Home First Community Support Team provides both short-term and longer term personal care services to people in their own home. The service focuses on promoting self-care and enabling people to reach or regain an optimum level of independence. The service also provides out of hours duty cover for the local authority. At the time of the inspection the service was supporting 119 people.
At the last inspection in January 2016 we rated the service ‘Good’ overall and in each domain. At this inspection we found the service had maintained its overall rating of ‘Good’ and improved its rating in the ‘Is the service Caring?’ domain to ‘Outstanding.’
We found an extremely caring service. Staff demonstrated very caring values and showed a very positive regard for what was important and mattered to people. They had developed very positive relationships with the people they supported. The trust developed between people and staff helped promote people’s independence, confidence and helped them achieve good outcomes. We saw staff regularly went the extra mile for people, to provide compassionate care which ensured people’s comfort and met their preferences.
Respect for equality, diversity and human rights was thoroughly embedded within the service and integral to everything the staff did. People were treated with dignity and respect by staff who understood the importance of this. The new ‘Moving with Dignity’ initiative gave people more choice, involvement and dignity around their care support.
People continued to feel safe using the service and staff ensured that risks to their health and safety were reduced. Recruitment procedures remained robust. There were enough staff to ensure a consistent and reliable service. Safeguarding policies and procedures were in place and staff were aware of the procedures to follow in the event of concerns. People were supported to take their medicines safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.
People’s nutritional needs were assessed and staff supported people to make sure they ate and drank enough. Staff worked closely with healthcare professionals to make sure the care and support met people’s needs and they received medical attention when necessary.
Staff received a wide range of training and we received positive feedback about the effective care and support they provided. Staff received regular supervision and an annual appraisal to support their continued professional development.
People received person-centred and responsive care from staff who had a clear understanding of their current support needs. People praised staff skill and knowledge and said staff knew their needs well. People were involved in setting their own goals which contributed to the successful reablement outcomes. People had good access to a range of aids and equipment which supported their safety and return to independence.
People were signposted and supported to access local community groups to promote inclusion, independence and a healthy lifestyle.
We received very positive feedback about the management of the service. People, relatives, professionals and staff told us the registered manager was very approachable, caring and responsive to feedback. They were also committed to delivering high quality care and fostered a person-centred, open and inclusive culture within the service. The service had recently undergone review and there had been many changes including the model of care, staff teams and roles. Staff felt supported through this process. A range of audits and checks were undertaken to ensure the service continued to perform to a high standard. People’s feedback was regularly sought to determine whether any improvements were needed to the service. Effective systems were in place to manage complaints and concerns.