Background to this inspection
Updated
1 March 2017
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 6 and 10 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk to staff and review records. The inspection team included one inspector and an expert by experience. An expert by experience is a person who has personal experience of using for caring for someone who uses this type of care service.
Before the inspection we looked at all of the key information we held about the service. We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the service. We also checked whether we had received notifications sent to us by the provider. Notifications are changes, events or incidents that providers must tell us about.
In addition, during our inspection spoke with eight people and one person’s relative on the telephone. We also spoke with the registered manager and provider. We spoke with one team supervisor who had responsibility for training, two senior care staff and two carers. In addition we spoke with one health care professional and one social care professional.
We looked at three people’s care plans and reviewed other records relating to the care people received and how the agency was managed. This included risk assessments, quality assurance checks, staff training and recruitment records.
Updated
1 March 2017
This inspection took place on 6 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk to staff and review records. Phone calls to people were completed on 10 January 2017.
The service provides personal care and support to people who live in their homes in and around the Shirebrook area of Derbyshire. At the time of this inspection 35 people received support from the agency, 28 of those people received support with their personal care needs.
The service is required to have a registered manager. 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 service could not demonstrate all the required pre-employment checks had been completed on staff employed at the service.
The service could not always demonstrate an accurate and complete record of medicines administered for people. In addition, not all audits designed to monitor the quality and safety of services were effective.
The provider did have a policy in place on the Mental Capacity Act 2005 however the service had provided restrictive care to a person without demonstrating the principles of the MCA had been followed.
There were sufficient staff deployed to meet people’s needs. Staff were organised to ensure people who required the support of two staff received this support and staff were organised to cover specific geographical areas.
People felt safe with the support they received from the service. Staff had been trained and understood their responsibilities for safeguarding people.
Risks in people’s homes were identified and assessed. We identified where risks to one person were known about by staff, however these had not been recorded in a risks assessment. The registered manager sent a completed risk assessment through shortly after our inspection. Procedures were in place for the reporting and investigation of accidents.
People commented that infection prevention and control practices had been improving. We saw this was an area monitored by the registered manager and senior staff to ensure staff practice continued to meet standards.
Staff had maintained up to date skills and knowledge in areas relevant to people’s care and support, including safeguarding people and assisting people to mobilise safely.
Staff understood how to support people with their nutrition and hydration needs. Staff provided care and support to help people with their meals and drink in a way that met their known preferences.
Staff felt supported by the registered manager and senior staff and had regular contact with them.
Staff were mindful of people’s healthcare needs and supported people to access other healthcare provision when required.
People were cared for by staff who were caring. Staff knew the people they supported and provided regular support to people. Staff promoted people’s dignity and privacy. People were involved in planning and reviews of their care and support.
People knew how to raise any worries or concerns. People received personalised and responsive care and their views and preferences were respected.
The service promoted an open and inclusive culture. The registered manager demonstrated and open and inclusive style of leadership.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection. You can see what action we told the provider to take at the end of the full version of this report.