Background to this inspection
Updated
28 August 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team:
This inspection was conducted by an inspector and Expert by Experience. The inspector visited the office to review records and speak with management and staff and the Expert by Experience spoke with people on the phone to seek their views about the care they received. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection:
Our planning took into account information the provider sent us since the last inspection. We also considered information about matters the provider must notify us about, such as events involving injury. We obtained information from the local authority commissioners and safeguarding team and other professionals who work with the service.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection:
We spoke with five people who used the service and five relatives. We spoke with the registered manager, a provider's representative, two senior staff who were based in the office and two care workers.
We reviewed four people's care records, four staff recruitment and personnel files, staff training documents and other records about the management of the service.
After the inspection:
We continued to seek clarification from the registered manager and provider representative to validate evidence found. We looked at training data, policies and quality assurance records.
Updated
28 August 2019
About the service:
Freedom and Lifestyle Limited is a care at home service providing personal care to 14 people at the time of the inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Personal care is help with tasks related to personal hygiene and eating. Where the service provides this help, we also consider any wider social care provided.
People’s experience of using this service and what we found:
People told us they received safe care and treatment. Staff undertook risk assessments for people they supported and any identified risks were managed well. Care staff understood the importance of safeguarding people they supported and they knew how to report accidents and incidents.
Consideration into a person's mental capacity was not dealt with entirely appropriately. This meant that the service may have been involved in unauthorised restrictions. We have made a recommendation about this that can be seen in the 'Effective' section of this report.
Staff had completed training in the safe administration of medicines. People were encouraged to maintain their independence and, where required, protocols were in place to support people to self-administer their own medicines.
People told us staff visited as planned and they were punctual. The registered manager had processes for monitoring visits and were planning to roll out new visit and support monitoring technology to enable the provider to monitor whether staff visited as planned.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff liaised with health care professionals and supported people to attend appointments. People were supported to make healthy choices in relation to lifestyle. People told us staff helped them to prepare meals and accompanied them to appointments.
Staff received training which enabled them to provide safe and effective care. Senior staff regularly observed staff in practice. Staff received regular supervision from the registered manager and told us they felt supported.
People and their relatives understood how to make a complaint. People told us they felt listened to. There had not been any complaints since the last inspection.
There was information available throughout people’s support plans which enabled staff to provide person-centred care. People and their representatives had been involved in the care planning process.
The registered manager maintained clear records of quality assurance and good governance. People and their relatives provided consistent positive feedback about the registered manager, office staff and individual members of the care staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 7 January 2107).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.