2, 3 and 8 December 2015
During a routine inspection
The inspection took place on 2, 3 and 8 December 2015 and was announced. The provider was given 48 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.
Self Direct Support Limited provides a personal care service to people living in their own home. On the day of the inspection 127 people were supported by Self Direct Support Limited with their personal care needs.
The service had 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.
On the day of the inspection staff within the office were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.
People and their loved ones spoke well of the care and support they received, comments included, “Absolutely the staff are caring, I’m very impressed with them” and “I’m happy with the care […] receives, they have a very caring nature”. Care records were personalised and gave people control over all aspects of their lives. People’s preferences were identified and respected. Staff responded quickly to people’s change in needs. People or where appropriate those who mattered to them, were involved in reviewing their needs and expressed how they would like to be supported and by whom.
People were supported by staff who put them at the heart of their work. Staff showed a kind and compassionate attitude towards people. Relationships had been developed and staff had an appreciation of how to respect people’s individual needs around their privacy and dignity.
People’s risks were managed well and monitored. People were promoted to live full and active lives. Staff gave people information about risks and actively supported them in the choices they had made, so that people had as much control and independence as possible.
People had their medicines managed safely. People received their medicines as prescribed, received them on time and understood what they were for. People were supported to maintain good health through regular access to health and social care professionals, such as GPs, social workers, occupational therapists and district nurses.
People told us they felt safe. Comments included, “I feel safe because the people I see are so nice and check how I am” and “I absolutely feel safe. They’re a very professional organisation”. All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
People were supported by staff who confidently made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected.
People were supported by staff who had received a thorough induction programme and on-going training to develop their knowledge and skills. A health care professional commented, staff liaised well with them to ensure they kept up to date with current best practice, and followed their advice to meet people’s needs.
People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.
The service had a policy and procedure in place for dealing with any concerns or complaints. Complaints had been responded to in a timely manner and thoroughly investigated in line with Self Direct Support Limited’s own policy and procedure. Appropriate action had been taken and the outcome had been recorded and fed back to people.
Staff described the management to be supportive and approachable. Staff talked positively about their jobs. Comments included, “We are asked to do things not told to. We are respected, we get thanked and the manager is hot on showing their appreciation. I feel like I matter”, “I love it here, it is completely different every day. It’s a reason to get out of bed in the morning and so rewarding” and “I just love my job, I really do love it. You have to have a certain desire and passion, and I have. I wish I had started caring a long time ago”.
There were effective quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents and concerns raised was used to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.