Background to this inspection
Updated
3 November 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place over two days on the 29 and 30 September 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
The inspection team consisted of two inspectors 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.
Before the inspection we reviewed the information we held about the service. This included details of its registration, previous inspection reports and notifications the provider had sent us. We spoke with four people that used the service and two relatives. We spoke with four staff. This included the registered manager, the senior carer and two care assistants. We examined six sets of care records relating to people that used the service and five sets of staff recruitment, training and supervision records. We looked at quality assurance and monitoring systems and various policies and procedures. We contacted the relevant local authority with responsibility for commissioning from the service.
Updated
3 November 2015
This inspection was carried out over two days on the 29 and 30 September 2015 and was announced. The previous inspection of this service was on 11 September 2014 and we found they were fully compliant at that time with all the outcomes we looked at.
The service provides support with personal care to adults living in their own home. At the time of our inspection 20 people were using the service, but the registered manager told us only six of those received support with personal care.
The service had a registered manager in place. 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 service had not carried out robust assessments of the risks people faced and there was limited guidance available to staff about how to support people in a safe manner. The service did not always keep a record of when they had supported people to take medicines. Staff did not undertake sufficiently comprehensive training about moving and handling and supporting people with the aid of a hoist. Care plans were in place but these did not contain personalised information about how to support individual people. Quality assurance and monitoring systems did not always identify deficiencies within the service, in relation to care planning and risk assessments.
The service had systems in place to reduce the risk of abuse and staff had undertaken training about safeguarding adults. There were enough staff employed to meet people’s needs. Robust staff recruitment procedures were in place.
Staff received induction training which included shadowing other staff. Staff had regular supervision meetings with a senior member of staff. People were able to consent to the care provided and make choices about their care. This included making choices about what they ate and drank. People were supported to attend medical appointments.
People told us that staff treated them with dignity and respect and behaved in a caring manner. They said their cultural and religious beliefs were respected. Staff understood how to promote people’s privacy and independence.
People told us they were involved in planning their care. Staff had a good understanding of people’s individual support needs. People knew how to make a complaint and the service had a complaints procedure in place.
People and staff told us they found the registered manager to be approachable and accessible.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.