A single inspector carried out this inspection. We had received concerns about the staffing arrangements and how complaints about staffing arrangements had been responded to. The focus of the inspection was to look at these areas and answer the key questions; is the service safe, effective, caring and responsive?
Below is a summary of what we found. The summary describes what people using the service and the staff told us and the records we looked at.
We spoke to four people who used the service, a relative and an advocate of two others and some of the staff.
Is the service safe?
We found that hazards to the people receiving a service and to the staff had been considered and measures put in place to reduce the risk of harm.
The staff and the provider understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and Deprivation of Liberty Safeguards (as they related to domiciliary care) and put them into practice to protect people.
Is the service effective?
People we spoke with told us they were satisfied with how staff supported them. Their needs had been assessed and their support planned and delivered as they wished. Staff we spoke with understood people's care needs and the support they were to provide.
The service had not always been able to provide staff consistently for some people using the service. The practice of having small teams supporting people meant that only a small number of staff knew each person's needs which limited how responsive the service could be when core staff were absent. In some cases the service had needed to ask relatives to provide the support their family member needed.
Is the service caring?
We found that people's needs were assessed and their support plans had been developed with their full involvement. The plans were detailed and personalised.
People told us that the staff who assisted them respected their wishes and let them plan and control their own lives. One person told us, 'I did my support plan with the team co-ordinator, I am always consulted.
People felt that the staff that supported them had the right attitude, were trustworthy and they felt safe with them in their home. A relative said, 'Staff have been brilliant, they have good ideas and are very practical'.
Is the service responsive?
People who used the service were asked each day for their views about their support and they were usually acted on.
People told us that they would feel confident talking to the staff who supported them if they were unhappy with aspects of their care.
We saw that comments and complaints were recorded and efforts were made to address concerns raised.
The provider had responded to the staffing difficulties by trying to recruit new staff but the steps taken had not been effective enough to prevent people using the service being affected.