4 December 2017
During a routine inspection
This announced inspection was carried out by one inspector and an expert by experience. The expert by experience had knowledge of care services including domiciliary services.
There was a registered manager in the service. 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.
We rated this service as Requires Improvement in September 2016. Following this inspection, we asked the provider to complete an action plan by January 2017 to show what they would do to improve the key questions ‘Is this service safe, effective, and well led?’ to at least good. This was because we found quality monitoring systems were not always effective and systems were not in place medicines were safely administered; to ensure safeguarding was responded to and people’s capacity was assessed where concerns had been identified.
On this inspection we found improvements had been made although further improvements were needed with how quality was reviewed within the service, and checks were needed in the office to ensure it was safe. We have made a recommendation about the management of quality systems.
People felt safe when being supported. The staff knew how to protect people if they suspected they were at risk of abuse or harm and how to report concerns. Recruitment checks were made to confirm staff were of good character to work with people and sufficient staff were available to meet people's support needs.
Risks to people had been identified and staff understood how to support people to reduce risk and protect them from potential harm without restricting their rights. People had support plans which reflected their specific needs and preferences for how they wished to be cared for. We found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about their care and staff knew how to respond if people no longer had capacity to make some specific decisions.
There was a small team of staff who had the skills to meet people’s needs. The support was flexible and responsive to changes. People received their care at a time they wanted it and they knew who would be providing their support. People were happy with how the staff provided care and were positive about the way staff treated them. People’s privacy and dignity were respected and upheld by the staff who supported them.
Risks to people’s health and wellbeing were assessed and plans were in place to monitor and to assist them in a safe manner. People felt comfortable raising any issues or concerns and there were arrangements in place to deal with people's complaints. People felt the staff had the right skills to provide the care they wanted.
People’s health needs were managed and the staff worked with health care professionals and helped people to attend appointments where necessary. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed needs.
People had developed good relationships with staff and the registered manager. Care was planned and reviewed with people and the provider ensured that people’s choices were followed.