30 October 2020
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.
The inspection was carried out by two inspectors, one assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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
We gave the provider 48 hours’ notice of the inspection. This was because we wanted to ensure the provider could provide a safe environment for their staff and our inspectors to work whilst adhering to COVID-19 safety precautions and guidelines.
Inspection activity started on 24 September 2020 and ended on 2 October 2020. We visited the office location on 24 September 2020.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
On this occasion, we had not asked the provider to send us a provider Information return (PIR). A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant.
During the inspection
We spoke with 21 people who used the service or their relatives about their experience of the care provided to them or their family members. We spoke with five members of the care staff, the training and policy officer, the finance director and the registered manager.
We reviewed a range of records. This included parts or all of 10 people’s care records, medication administration records and the daily notes recorded by care staff. We looked at a variety of records relating to the care people received and the management of the service, including policies and procedures and training records.
After the inspection
We asked the registered manager to provide us with a variety of policies and procedures and additional information after the inspection. All information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.
30 October 2020
About the service
Forever Independent is a domiciliary home care service providing personal care to adults with personal care needs. They were providing a service to 63 people at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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 felt safe when staff cared for them in their homes. People told us staff were punctual and they normally received care from a consistent team of staff team. At the last inspection there were concerns with the way the provider managed people’s medicines. The provider had acted to address this, and, apart from one issue in relation to person’s medicine administration records, we saw these improvements had reduced the risks to people’s safety.
There was a process in place to investigate accidents and incidents and to ensure safeguarding concerns were reported to the relevant authorities. The provider had made changes to the way risk to people’s health and safety were assessed and recorded. This resulted in more detailed care planning and risk assessments. Robust infection control procedures were in place. This included how to reduce the risk of the spread of COVID-19.
People’s physical, mental health and social needs were assessed and met in line with current legislation and best practice guidelines. This included guidance in place for staff to identify the first signs of a person having a stroke.
Staff were well trained, and they received regular supervision of their practice to ensure they continued to care for people in a safe and effective way. People were supported to lead a healthy and balanced lifestyle with risks to people’s dietary needs assessed and acted on. This included guidance for staff to support people who had diabetes. The provider had effective relationships with external health and social care organisations and people’s health was regularly monitored. 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.
Improvements had been made to the overall governance of this service. The improvements required from the previous inspection had been implemented and were showing sustained improvement. The registered manager had a good understanding of the regulatory requirements of their role and had now ensured the relevant authorities were always informed of any incident or death that occurred at their service.
People praised the approach of staff and the registered manager. They felt safe, well cared for and they had confidence that risks to their health and safety were well managed. Most of the people we spoke with would recommend this service to others.
People and staff felt well supported during the height of the COVID-19 pandemic. Staff wellbeing was actively supported and monitored.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 25 July 2019). There were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 22 May 2019 where breaches of legal requirements were found.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires Improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forever Independent on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.