Heart of the South Cornwall Branch

People’s experience of using this service:

The service had systems to ensure risks were managed and people were kept safe. People received effective care from a well-supported and trained staff team.

People received personalised care that was responsive to their needs and preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff understood the importance of respecting people’s abilities and promoting independence. Staff had built positive caring relationships with people they supported and their families.

Care plans adopted a person-centred method of supporting people. Information focused on what support was required and people or their representatives had consented to receive support from Heart of the South.

People supported by the service told us they were treated with respect and by caring staff. Comments included, “They have been so supportive of me and making sure my needs are met” and “Having the support here means I can stay in my own house. I feel very well cared for”

Staff were motivated by and proud of the service. One staff member said, "I just feel we do a great job and it means clients don’t have to go into a care setting.” There was an emphasis on continuous improvement with staff having the opportunity to gain additional qualifications. A staff member said, “We are really encouraged to do more training. The managers are behind us in that.”

Staff had opportunities to raise concerns or suggestions and be involved in the development of the service.

The service worked in partnership with other organisations to ensure they followed good practice and people in their care were safe.

The registered manager and management team used a variety of methods to assess and monitor the quality of the service. These included staff meetings, spot checks, auditing of the service and surveys to seek people’s views about the service provided.

Rating at last inspection: Good. The last inspection report was published 7 October 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remains Good.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated Good.

This inspection took place on 23 and 24 August 2016 and was announced. This meant we gave the provider short notice of our intended visit to ensure someone would be available in the office to meet us. This is the first inspection since registration in February 2016.

There was a registered manager in post. 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 registered manager informed the commission in March 2016 that they would be on maternity leave until March 2017. They named a person who would be covering the day to day management of the service. On the first day of the inspection the provider and registered manager informed the inspector the interim manager had left the service. They were taking steps to employ another interim manager and would inform the commission as soon as a suitable candidate had been employed. In the meantime the provider agreed to keep the registered manager informed of operational issues.

People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. However, during a home visit a care plan had been removed to update information. The provider was informed of this and addressed the issue immediately.

The service’s risk assessment procedures had been developed to include all areas of support while providing appropriate protection.

People told us they felt safe and secure when receiving care. People received consistent support from care workers who knew them well. People told us, “Can tell from smile that (person’s name) is calm and happy when carer arrives.” A person with limited communication smiled to acknowledge they felt safe and secure when being cared for and supported.

The two people being supported by the service had consistency in the staff who supported and cared for them. The way staff were deployed meant they had time to meet people’s needs and provide a flexible service. People and their relatives told us they knew their care workers and communication with the main office and manager was good. A relative told us they would have no hesitation in contacting the office if they had any issues. They told us, “If I had a problem I have the information leaflet but I would also speak with (managers name) if I felt I needed to.”

Staff received training and were knowledgeable about their roles and responsibilities. People said they were satisfied with the way staff supported them and understood how to meet their specific care needs. A relative told us, “(Staff name) is still getting to know (person name) but I am impressed with how quickly (staff name) has picked up their needs and how to respond to them.” A staff member said, “We are well informed about people’s needs before we support them”. Training records showed staff had been provided with all the necessary training which was refreshed regularly. Staff told us they had “good access to training” and found the training to be beneficial to their role.

Staff told us they felt supported in their role and the on- call arrangements provided people and staff with appropriate support when the service was closed. Staff had received supervision and annual performance appraisal plans were in place. In addition ‘spot checks’ had taken place to confirm each member of staff was providing appropriate standards of care and support.

Recruitment systems were in place to ensure staff were suitable and safe to support people in their own homes. Necessary pre-employment checks had been completed. Staff received a full induction to understand their role and to ensure they had the skills to meet people’s specific needs. This helped ensure people received care and support from staff who were competent and well matched to the role.

Audit systems were in place to monitor and manage how care and support was being delivered to people. Auditing procedures took account of accidents and incidents, as well concerns and complaints. These systems acted as early indicators of themes or trends which might affect individuals using the service or staff supporting people. There was a system in place to gain the views of people using the service. The small client base was regularly communicated with and there was regular dialogue with people using the service and their relatives.