Background to this inspection
Updated
20 December 2019
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
The inspection was completed by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.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.
Inspection activity started on 06/11/19 when we visited the location and ended on 12/11/2019
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a 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. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and six relatives about their experience of the care provided by telephone. We spoke with the registered manager (also the provider), and five staff including seniors and care staff. We reviewed a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found through discussion and feedback to the registered manager.
Updated
20 December 2019
About the service
Vicarage Home care providing personal care to younger and older adults who may live with dementia, a learning disability, mental health needs, physical disabilities or a sensory impairment. At the time of our inspection the service was supporting 44 people.
Not everyone who uses the service may receive 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
Quality monitoring systems were in place although there was some scope where improvements could be made in respect of record keeping related to daily records and risk assessment.
There had been a lack of adherence to some regulatory requirements in respect of notifications to CQC and display of the last CQC report rating. Whilst these matters were addressed during our inspection, it did identify there had been a gap in knowledge of the law by the provider.
The provider (who was also the registered manager) was open and honest and had taken steps to address any issues we raised.
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People were protected from potential risks as staff had a good awareness of what these were and how to mitigate them, However, there was scope for some areas of risk assessment to be formalised to reflect staff knowledge.
Overall, people were satisfied with the arrangements for management of their medicines.
People were supported to have choice and control of their lives and staff supported them where possible in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported by enough staff, who were caring and had developed good relationships with them. Staff showed respect for their rights, privacy, dignity and independence. Checks of staff when employed ensured they were safe to work with people who used the service.
People felt able to share their views with the provider and staff and people felt if they raise any concerns the provider would do what they could to put things right. Staff were knowledgeable about people’s needs and preferences and people told us they had good relationships with all staff.
People were supported by care staff who had the range of skills and knowledge to meet their needs. Staff understood their role, and they felt well supported with access to regular supervision.
People's health was supported as staff worked with other health care providers to ensure their health needs were met.
People were supported by staff to have choices, and the provider’s policies supported this practice. Recording of the specific decisions people could make could have been better recorded, although people were always asked for their consent by staff. People’s likes and dislikes as well as diverse needs were well known and respected by staff.
People could raise concerns and the provider had systems in place to investigate, monitor and respond to these.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 04 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
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.