Background to this inspection
Updated
13 July 2017
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.
Our inspection took place on 8 and 9 June 2017, was unannounced and undertaken by one Inspector.
We reviewed the information we held about the service, including statutory notifications that the provider had sent us. A statutory notification is information about important events which the provider is required to send us by law.
During this inspection we spoke to two people receiving care from CareXL and one person’s relative. We also looked at care records and charts relating to three people. In total we spoke with four members of staff, including two care staff, registered manager and the provider. We also spoke to local health and social care commissioners who commission care from CareXL. We looked at three records in relation to staff recruitment and training, as well as records related to the quality monitoring of the service.
Updated
13 July 2017
This inspection took place on 8 and 9 June 2017 and was unannounced. CareXL is registered with the Care Quality Commission (CQC) to provide personal care and delivers a domiciliary care service to people living in their own homes. At the time of the inspection CareXL was providing 137 hours of care and support each week to 16 people.
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.
Since our last inspection in November 2016 the provider had strengthened the quality assurance processes that they used to monitor the care and support that people received. People could now be assured that a system of quality assurance was used that was well coordinated and effective at levering improvements in people’s care and support. However. These systems had been recently introduced and were not yet embedded into practice. The leadership, governance and provider oversight had improved and the registered manager was now well supported by a visible provider. However. when we inspected in November 2016 the well-led domain was rated as inadequate. The provider has provided evidence that improvements have been in place since March 2017 and we have rated well-led as requires improvement because the provider has not demonstrated a sufficient track record of compliance to reflect a rating of good.
The provider had also made improvements to the way in which people’s medicines were managed. People could now be assured that they would receive their prescribed medicines safely.
People were safeguarded from harm as the provider had effective systems in place to prevent, recognise and report concerns to the relevant authorities. Staff knew how to recognise harm and were knowledgeable about the steps they should take if they were concerned that someone may be at risk.
People’s care records contained risk assessments and risk management plans to mitigate the risks to people. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.
Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.
Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.
People’s needs were met in line with their individual care plans and assessed needs. Staff took time to get to know people and ensured that people’s care was tailored to their individual needs.
People had the information they needed to make a complaint and the service had processes in place to respond to any complaints.
People were supported by a team of staff that had the managerial guidance and support they needed to carry out their roles. The provider and senior management team were visible within the service and were accessible to staff and people receiving care and support.