Background to this inspection
Updated
19 January 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 was planned to check whether the provider was 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.
The office visit took place on 21 December 2017 and was announced. We told the registered manager 48 hours before our visit we would be coming so they could make sure they would be available to speak with us. The inspection was carried out by one inspector.
Prior to our office visit we reviewed the information we held about the service including statutory notifications that had been sent to us. A statutory notification is information about important events which the provider is required to send to us by law. We also spoke to the local authority commissioning team. They did not have any further information to share with us.
The registered manager sent us a list of people who used the service. Before our visit we spoke with two people and one person’s relative via the telephone to gather their views on the service they received. We also spoke with two care workers and we used this information to form part of our judgements.
During our office visit we spoke with the registered manager, the managing director and the compliance office manager. We reviewed two people's care records to see how their care and support was planned and delivered. We looked at two care workers recruitment records to check whether they had been recruited safely and were trained to deliver the care and support people required.
We looked at other records related to people's care and how the service operated, including the service's quality assurance audits.
Updated
19 January 2018
Structured Care Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and operates in Solihull, West Midlands. There were three people using the service at the time of our inspection.
We visited the offices of Structured Care Ltd on 21 December 2017. This was the first inspection of the service since registering with the Care Quality Commission in July 2016. We gave the registered manager 48 hours' notice of the inspection visit because it is small and the manager is often out of the office providing care. We needed to be sure that they would be in.
The service is required to have 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 and associated Regulations about how the service is run. At the time of our inspection there was an experienced registered manager in post who was also the provider.
Everyone we spoke confirmed they felt safe with their care workers because they trusted them. Care workers were recruited safely and there were enough of them to support people safely in a timely way. Care workers had received training to safeguard adults and they understood their responsibilities to keep people safe.
Procedures were in place to protect people from harm and people told us they knew how to report concerns if they felt unsafe. Risk assessments were in place and identified potential risks to people's health and wellbeing which helped to keep people and care workers safe when delivering care.
A business continuity plan was in place to make sure the service could respond to emergency situations such as, adverse weather conditions. Care workers told us their managers where available at any time if they had any worries or concerns.
A system was in place to record accidents and incidents and to reduce any reoccurrence.
Care workers understood their responsibilities in relation to infection control.
Care workers and the registered manager had the skills and knowledge they needed to provide the care and support people required. New care workers were provided with effective support when they first started work at the service. Care workers were provided with support through individual supervision and by working alongside the registered manager to provide care and support to people.
People were supported to manage their health conditions and to access other professionals when required. Care workers knew how to monitor and manage people's nutrition and hydration if this was required to make sure people's nutritional needs were maintained.
Care workers demonstrated an understanding of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) so that they could ensure peoples' rights were being protected. The registered manager understood their responsibility to comply with these requirements.
People told us care workers were kind and caring. Care workers we spoke with were proud of the high quality care they provided to people. People told us they were always treated with dignity and respect and the service was committed to ensuring peoples diversity was respected. People were supported to be as independent as they wished to be.
The registered manager and care workers knew what was important to people which
meant people received care and support in line with their wishes and preferences. Care records were personalised and contained information about people's life histories and daily routines. People and their relatives told us they were involved in their care, and their care plans were reviewed monthly.
People were provided with information which contained up to date information about the service so they knew what to expect. Care workers visited the same people and they had enough time to provide care and also sit and chat with people.
People and their relatives knew how to make a complaint and felt comfortable doing so.
Everyone told us the service was well led and they could not think of anything that would improve the service they received. Care workers had a clear understanding of their roles and responsibilities. They enjoyed working at the service and they felt supported by the registered manager.
There were effective systems to monitor and review the quality of the service. The registered manager used a variety of methods to ensure they kept their knowledge up to date to continually improve the service provided. The service had invested in resources and 'compliance tool kits' which the registered manager told us helped them to demonstrate their compliance with regulation.