Background to this inspection
Updated
11 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was undertaken by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave four days’ notice of the inspection because some of the people using it could not consent to a home visit or telephone call from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.
Inspection activity started on 14 January 2020 and ended on 17 January 2020. We visited the office location on 16 January 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications about various incidents the provider must tell us about. We sought feedback from the local authority and professionals who work with the service. The provider sent us their provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with six people and two relatives of people who used the service about their experience of the care provided. We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with seven staff including care coordinators, administration staff, field care supervisors and care staff.
We reviewed a range of records. This included two people’s care records and their medication records. We looked at one new staff recruitment file and records relating to training and supervision. A variety of records relating to the management of the service, including compliments, audits, accident and incident records were also reviewed.
Updated
11 February 2020
About the service
1st Homecare Solutions Limited is a domiciliary care agency providing support to 74 people of which 58 were receiving personal care. This service is provided to younger and older people, people with a physical disability and people living with dementia.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found.
People's care was exceptionally person centred and based completely on what mattered and was important to them. People lived lives they might not otherwise have done. One person said, “The difference staff make is that without them I wouldn’t be living at home.” Concerns were resolved before they became a complaint. Compliments were used to identify what worked well. Another person told us, “I have found a care service that truly meets my needs.” Systems and procedures were in place to support people with end of life care and in a dignified way.
Sufficient staff were recruited safely and deployed in a way which kept people safe. Staff implemented their knowledge of hygiene and safeguarding systems well. Risks were identified and managed well. One person told us, "There are two staff who help me. They arrive together. I feel safe in their hands. I need that assurance." Lessons were learned when things went wrong.
People's assessed needs were met by staff with appropriate skills and whose induction, supervision and training was kept up-to-date. The provider worked well with others involved in people's care, people benefitted from this. People ate and drank enough. Staff enabled people to access healthcare and support services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice.
People's care was kind, dignified and staff were thoughtful about how they supported each person. Staff respected people's privacy and upheld their confidentiality. People who needed support from an advocate were given this. People had a say in developing their care and how it was provided.
The registered manager was aware of their responsibilities and sought to identify and drive improvements. The registered manager supported staff who worked well as a team. People, relatives and staff had a say in how the service was run. Quality assurance, audits and governance were effective in identifying and driving improvements. The provider worked well with others to provide people with joined up care.
Rating at last inspection.
The last rating for this service was good (published 3 August 2017).
Why we inspected
This was a planned inspection based on the previous inspection rating.
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.