Background to this inspection
Updated
1 December 2018
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 on 8 and 11 November 2018 and was announced on both days.
This inspection was carried out by one adult social care inspector.
Prior to the inspection the provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We used this information as part of our inspection planning and throughout the inspection process.
We checked the information we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law.
During our inspection we visited three people and their relatives within their homes. We spoke with three support workers and the two registered managers. We spoke to three people who use the service and their relatives by telephone.
We spent time looking at records, including two care plans and risk assessment files, two staff recruitment and training files, medication administration records (MARs), daily records, complaints and other records that related to the management of the service.
Updated
1 December 2018
This inspection was undertaken on 8 and 14 November 2018 and was announced on both days.
Happier at home is registered to provide personal care and support to people who live in their own homes. The agency office is based in Ellesmere Port and provides support to people in Ellesmere Port, Neston and surrounding areas. At the time of our inspection the service supported 18 people and employed eight staff.
The service had two registered managers. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are registered persons. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection on 7 and 11 September 2017 we found that there were some improvements needed in relation to staffing. This was a breach of Regulation18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We asked the provider to complete an action plan detailing how and when they would make improvements to the areas that were highlighted in the last report. During this inspection we found all the required improvements had been made.
Improvements had been made to the staffing systems. Staff had all received an induction and up-to-date training and had their competency assessed. Staff had all received supervision and an annual appraisal.
Staff recruitment systems were robust and this helped to ensure only staff suitable to work with vulnerable people were employed. New staff completed the Care certificate, undertook shadow shifts and commenced lone working when they felt confident and competent to do so. Team meetings were held each week with the registered managers.
The registered provider had safeguarding policies and procedures in place. Staff had all completed safeguarding training and demonstrated a good understanding of what abuse may look like. Staff were clear about the process to follow should they have any concerns and felt confident that the management team would act promptly on these.
People were assessed before they were supported by the service. The information from these assessments was used to prepare individual care plans and risk assessments. People’s needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. The care plans and risk assessments gave clear guidance to staff to ensure that people’s individual needs and preferences were met.
Staff had all undertaken medicines training and had their competency regularly assessed. Medicines management systems were in place and staff followed best practice guidelines. People told us their received their medicines correctly and on time.
People told us that staff supported them with their food and drink needs as required. They told us they were always offered choice and we saw guidance was in place for staff to follow to meet people specific dietary needs.
People spoke positively about the staff that supported them and told us they had developed positive relationships. Staff knew people well and treated them with kindness. Interactions between people and staff were comfortable and friendly. People told us their privacy and dignity was respected and their independence was promoted where possible.
The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for staff in relation to the MCA. Staff had received training in relation to the MCA and demonstrated a basic understanding of it.
The registered provider had a complaints policy and procedure in place. People told us they felt confident to raise any concerns they had and thought they would be listened to.
The registered provider had quality monitoring systems in place that were followed by the management team to identify areas for development and improvement.
The registered provider had policies and procedures in place that were regularly reviewed and updated. These gave staff guidance in areas of their work role and employment.