Silverbell Care

At our last inspection on 9 and 13 February 2017 we found improvements were needed to safe recruitment practices, how competency checks and training for staff were carried out, quality checks were not effective and feedback on the service was not used to make improvements. At this inspection we found the provider had made the required improvements but more were needed to ensure people could have the support they wanted at the time they preferred.

SLR care is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults. At the time of our inspection there were 43 people using the service.

There was a registered manager in post at the time of the inspection. 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.

People were not always able to have their preferred call times, although steps were being taken to address this. People’s preferences were understood by staff. However, the detail was not always recorded in peoples care plans.

People were safeguarded from abuse and there were plans in place to minimise risks to their safety. Medicines were administered safely to people by trained staff. People were protected from the risk of cross infection. The registered manager had systems in place to learn when things went wrong.

People had their needs assessed; and care plans were in place to guide staff to provide care and support. People were supported to have maximum choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice. People received support to maintain a healthy diet and were supported to maintain and monitor their health and well-being. People received consistent care from staff that understood their needs and preferences.

People were supported by caring staff that protected their privacy and dignity. People had their communication needs assessed and plans were in place to meet those needs. People had support to make decisions and choices about their care and maintain their independence.

People understood how to make a complaint. The service was not supporting people with end of life care. There were systems in place to monitor the quality of the service and these were used to drive improvements. A registered manager was in post; and people, relatives and staff were able to approach the registered manager.

SLR Care is a domiciliary care service and is registered to provide personal care to people living in their own homes. There were 23 people using the service on the day of our inspection.

A registered manager was in post and was present during our inspection. 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.

The provider had not used safe recruitment practices to establish if staff were suitable to work with people who used the service. Pre-employment checks were not always carried out on potential new staff.

The provider did not have effective systems in place to monitor and assess the quality of care provided to people. Records were not available and poor practice was identified where records had been amended. There was no evidence of quality checks completed on records or on staff which would identify poor practice.

The provider sought people’s opinions of the service but did not share their findings with people or their relatives.

People were supported to give their consent and make decisions about their day to day care. However, not all staff were confident on how they would support people who had no or variable capacity to make their own decisions. There was a risk people's rights may not be promoted due to staff not having the knowledge needed to ensure decisions would be made in their best interests and in line with current law.

People were happy with the support they received with their medicines. Staff had received training to help people with their medicines but not all staff had been observed to make sure they were competent in this role.

People felt safe when staff supported them. Staff understood how to protect people from any harm and abuse. Systems were in place for staff to follow and they were confident in reporting any concerns they may have about a person’s safety.

Risk assessments reflected how care should be provided to the person to minimise any risks to them. These were regularly reviewed to meet people’s changing needs.

People were happy they were supported by sufficient numbers of staff to safely meet their needs. Staff were punctual when attending care calls and would let people know if they would be late.

Staff had received training to help them understand and support people's individual needs. These skills were kept up to date through regular training and staff were also supported in their roles by managers and their colleagues.

People were supported with their meals and drinks when necessary. Staff supported people with their routine health needs where required and made sure they had access to healthcare service when needed.

People were supported by staff who knew them well and had good relationships with them. Staff made sure people were involved in their own care and made sure they understood information that was given to them. People were treated with dignity and respect and staff understood how important this was in the way they cared for people.

People were involved in the planning and assessment of their care and were encouraged to express their views, preferences and wishes in regard to the care they received. People knew how to raise complaints but told us they had not needed to.

People were happy with the care and support they received and gave positive comments about the staff and the service. Staff were happy in their work, understood their roles and felt supported by management.

You can see what action we told the provider to take at the back of the full version of the report.