Independent Living (Chorley, Leyland, Parbold & Standish)

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

There were issues around the safe recruitment of staff. Some pre-recruitment checks were not made in the four files we considered and, in one case, the service could not be satisfied that a member of staff had been safely employed. We found no evidence people were at risk of harm from this concern. This has resulted in making a recommendation that can be seen in the 'safe' section of this report.

Although we were satisfied people received their medicines as prescribed, some aspects of medicines administration and recording were not always safe. We have made a recommendation about this in the 'safe' section of this report.

People told us they felt safe. Staff understood their responsibilities about keeping people safe. Risks were identified and managed. Incidents and accidents were recorded so that they could be considered and reflected upon to make improvements to the service. Staff understood their responsibilities to prevent the spread of infection whilst working in and between people's homes.

People told us staff were kind and caring. People said staff, including the registered manager, had met their expectations of a care service. People and relatives had a high levels of trust in staff which had a positive impact on their wellbeing. People and relatives described staff as "good and caring". Staff supported people to remain independent and promoted their dignity. People's privacy was respected and their personal information was kept confidentially.

Staff had completed training in key areas and were supported to carry out their roles. People and relatives had confidence in staff and were content with the care they received. People were supported to access health services if needed. People's dietary needs were assessed and, where required, they were supported with their meals.

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

People's care plans were up to date about their individual needs and preferences. People received support that met their needs. People and their relatives knew how to complain, although none we spoke with had any complaints.

The service was managed by a registered manager who had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. There were quality assurance systems in place to monitor the quality and safety of the service. There was a focus on continuous improvement.

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

Rating at last inspection

The last rating for this service was good (published 05 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Independent Living (Chorley, Leyland, Parbold & Standish) were previously registered with the Care Quality Commission as a franchise of the Right at Home brand. Since our previous inspection in September and October 2015 the service had bought the Right at Home franchise and were now operating independently as Independent Living (Chorley, Leyland, Parbold & Standish). The services were however operating from the same office location and the owner and registered manager remained the same, as did many of the staff and people receiving care from the service.

We therefore ensured that the issues highlighted within the previous inspection were reviewed even though the services registration had changed. At our previous inspection, as part of the Right at Home franchise, we found the service was not meeting four of the regulations that we assessed and we asked the provider to take action to make improvements. The four breaches of regulation were in relation to gaining valid consent from people prior to their care and support being delivered; the lack of established systems and processes in place to effectively assess and monitor service delivery; staff not receiving appropriate support via robust training, supervision and appraisals and the lack of an effective recruitment procedure for staff.

We issued four requirement notices and asked the registered provider to tell us how they were going to make the improvements required. At this inspection we found that the registered provider and registered manager had made the changes and improvements needed to meet all the requirement notices issued from the previous inspection.

Independent Living (Chorley, Leyland, Parbold & Standish) is a domiciliary care service based near Chorley town centre. The agency supplies staff to work across Chorley, Leyland, Parbold and Standish. The service provides support to people living in their homes and is regulated to provide people with support with their personal care needs. The service offers other support such as help with domestic tasks, shopping and also provide end of life support. At the time of our inspection the service was providing support to 60 people permanently and 13 other people via respite and ad hoc care packages. This totalled approximately 450 hours of care per week.

People told us that they felt safe when receiving care and support from staff employed by Independent Living. Staff knew how to recognise and report potential safeguarding issues and they received appropriate training in this area. However one person who received help with their finances did so in contradiction of the agency's own policies and procedures. We have made a recommendation about this.

People we spoke with had no concerns with how staff helped them to take their medication. An up to date medication policy was in place that staff were aware of. Staff knew their responsibilities in this area and were trained to administer people’s medicines.

Staff received an induction when they first started work at the service. We saw evidence to show that staff were trained, supervised and received an annual appraisal of their performance. Staff told us they felt supported in their role and were given the appropriate training and guidance to carry out their duties effectively.

The service was broadly working to the principles of the Mental Capacity Act (2005). However we found some areas that required improvement, namely how people’s consent was gained and recorded as in some instances people’s care plans were contradictory in this regard. We have made a recommendation about this and saw that action had been taken when we returned to the service to give formal feedback.

People we spoke with told us they were happy with the care and support they received and that staff were caring and considerate. Nobody we spoke with raised any issues about how staff conducted themselves when providing care in their home.

The agency provided end of life care to people. We gained positive feedback from relatives whose loved ones had received end of life care. Only staff who expressed an interest in this area of care were expected to provided care and support to people at end of life.

Care plans we reviewed were seen to be person centred and contain detailed information about each person. This included, were people wanted it included, information about people’s life and work histories.

People knew how to raise issues or make a complaint and told us they were confident if they did that an effective response would be gained. Staff spoken with knew the agency’s complaints policy and how to assist people to raise concerns if needed.

People and relatives we spoke with talked positively about the management of the service, the staff and the care and support they or their loved ones received.

We saw evidence of an effective auditing and monitoring system. We also saw that people were regularly asked their opinion of the service via a number of methods including annual quality surveys, phone calls and care reviews.