11 September 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 checked 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 15 August 2018 and was announced. We provided 48 hours’ notice of the inspection to ensure management were available at their office to facilitate our inspection. The inspection was carried out by one inspector.
Prior to our inspection, the provider 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 improvements they plan to make. We took this information into account during our inspection of the service.
As part of the inspection, we reviewed information we held about the service in the form of statutory notifications received from the service and any safeguarding or whistleblowing incidents, which may have occurred. A statutory notification is information about important events, which the provider is required to send us by law. We also asked commissioning teams from local authorities and Healthwatch for any information they had, which would aid our inspection.
At the time of our inspection, the service was providing personal care for 22 people who lived in the Herefordshire area. Some of these people were receiving 24 hour care from the provider. We spent time visiting people in their own homes and asked them and their relatives what they thought about the care they received. We also undertook telephone interviews with people and relatives to gauge their impressions of the quality of care provided. One person chose to write to us with their opinion of the care provided. Some people had difficulty in communicating verbally with us, and therefore conversations were limited. In total, we spoke to five people who used the services and four relatives.
At the office, we reviewed three care records about people’s care and other records on how the agency was managed. This included medication administration records, personnel and recruitment records, and quality assurance checks.
As part of the inspection, we spoke with the registered manager, the chief executive, the deputy manager, the human resources and training manager, five care staff, and three team leaders.
11 September 2018
This inspection took place on 15 August 2018, and was announced.
Services for Independent Living provides services that enable people to live independent lives in their own homes within their own community. They support people with learning difficulties, physical impairments, mental health issues including dementia and older people. Services are provided to people living in Herefordshire and the surrounding area. At the time of our inspection the provider was providing personal care and other support for 31 people. Not everyone using Services for Independent Living are at Home receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service was providing personal care for 22 people.
At the last inspection on 1 December 2015 November 2015, the service was rated 'Good.' At this inspection we found evidence continued to support the overall rating of 'Good.' This inspection report is written in a shorter format, because our overall rating of the service has not changed since our last inspection.
People continued to feel safe with staff and the support provided by Services for Independent Living. Staff understood their responsibilities to protect people from abuse, discrimination and avoidable harm. Risks to people continued to be managed in a way that protected them and kept them safe from avoidable harm. The provider continued to follow safe recruitment practices to ensure prospective staff were suitable to work with people in their own homes. The provider had systems in place to ensure they reflected on any shortcomings and that improvements were made. The provider had systems and procedures in place to ensure people received their medicines safely and as prescribed.
People continued to receive effective care and support from staff who had the skills and knowledge to meet their needs. People's rights with regards to consent and making their own decisions continued to be respected by staff. People were supported to choose the food and drink they wanted, with regard to healthy diets and balanced nutrition.
Staff who adopted a warm, friendly and caring approach. People felt involved in their own care and staff and managers listened to what they wanted. Staff respected people's privacy and dignity when they supported them and promoted their independence.
People continued to receive care and support that was individual to them. The provider ensured people were provided with information appropriate to their disability, impairment or sensory loss. Support needs were kept under review and people were consulted about whether changes were required. People were encouraged to raise concerns and make complaints and were confident these would be dealt with. People continued to be involved in meaningful and stimulating activities of their choice.
Staff describe a culture in which they were able to speak openly with the registered manager and management team. People were listened to when they gave feedback about the service they received. Systems were in place that continued to be effective in assessing and monitoring the quality of the service provided. When concerns were identified the registered manager addressed these matters with staff at team meetings, where good practice and learning was shared. Staff and management worked to strengthen links with people and the local community.
Further information is in the detailed findings below.