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Inspection Summary


Overall summary & rating

Good

Updated 9 February 2018

The inspection took place on 22 January 2018 and was announced. We gave the provider two working days' notice of the inspection as the service provides care and support to people living in their own homes and we needed to make sure the registered manager would be available to assist with the inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger people with learning/physical disabilities. There were 13 people using the service at the time of this inspection. There were four people receiving 24 hour live in support from the service and one person funded their own care. The remaining people’s care was funded through social services or the Clinical Commissioning Group (CCG).

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.

Following the last inspection on the 6 and 7 December 2016, we rated the key questions, ‘Is the service safe?’ and ‘Is the service well-led?’ ‘Requires Improvement’ and the service overall was rated ‘Requires improvement’. We also found a breach of the regulation in relation to good governance and asked the provider to complete an action plan to tell us what improvements they would make at the service. They told us they would make the necessary improvements by 20 February 2017.

During this inspection we found that the provider had made improvements to the quality assurance systems at the service. The provider had introduced documents relating to medicines management and the management of any associated risks to help ensure people safely received their medicines.

There were sufficient numbers of care workers employed to meet people’s needs. Recruitment checks were carried out on new staff to make sure they were suitable to work with people using the service. One piece of information was missing from staff employment history which the provider addressed at the time of the inspection.

Feedback from people using the service and their relatives was mainly positive. They described care workers as caring and friendly and that there was good communication between them and the office.

The care workers we received feedback from were complimentary about the service and the support they received.

The provider had systems to safeguard people from abuse. Care workers completed safeguarding training and knew how to report any concerns.

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

People's needs had been assessed in line with good practice guidance and they had been able to express their views and preferences. Where people needed support with their health care or nutritional needs, their care workers provided this.

Care workers received support through one to one and group meetings. They also received an annual appraisal of their work. Training was provided on various topics and refresher training had been arranged that was relevant to their roles and responsibilities.

People were protected from the risk of infection as the care workers wore protective equipment, such as gloves and aprons, when providing care.

People and their relatives told us they knew how to make a complaint and there were systems in place to manage and respond to complaints.

Inspection areas

Safe

Good

Updated 9 February 2018

The service was safe.

There were systems to safeguard people from abuse. Staff completed safeguarding training and knew how to report any concerns. Safeguarding records needed to clearly show if these were ongoing or closed.

The provider had carried out recruitment checks. Dates of employment needed to be recorded to ensure there were no unexplained gaps in employment.

People safely received their medicines.

The risks to people's safety and wellbeing were assessed and planned for.

There were sufficient numbers of suitable staff employed to meet people's needs and keep them safe.

People were protected by the prevention and control of infection.

Action was taken to learn from incidents and events and to make improvements where necessary.

Effective

Good

Updated 9 February 2018

The service was effective.

People's needs and choices were assessed in line with current legislation and standards.

People were cared for by care workers who were well trained and supported by the provider.

The provider was working within the principles of the Mental Capacity Act 2005.

People were supported to have access to healthcare services and were supported to meet their nutritional needs.

Caring

Good

Updated 9 February 2018

The service was caring.

People were treated with kindness and respect.

People were involved in making decisions about their care and expressing their views.

People's privacy, dignity and independence were promoted.

Responsive

Good

Updated 9 February 2018

The service was responsive.

People using the service received care and support that was personalised and responsive to their needs.

The provider had systems to respond to complaints they received.

Well-led

Good

Updated 9 February 2018

The service was well-led.

There were systems in place to assess, monitor and improve the quality of the service.

People using the service were invited to share their views about the service and these were listened to and acted upon.

The provider worked closely with other professionals in order to meet people’s needs and to review service delivery.