Background to this inspection
Updated
15 August 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 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 the 18, 20 and 22 June and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that the registered manager was available given that this was the service’s first inspection.
Inspection site visit activity started on 18 June 2018 and ended on 22 June 2018. It included contacting people who used the service by telephone in order to gain their experiences and this was done on the 20 June. The other dates involved visiting the office location to see the registered manager, talk to the staff team, to review care records and policies and procedures.
The inspection team consisted of one Adult Social Care Inspector and an Expert by Experience. An expert-by-experience is a person who has experience of caring for someone who uses this type of care service. The expert-by-experience spoke to people who used the service to gain their views.
Before our visit, we reviewed all the information we had in relation to the service. This included notifications, comments, concerns and safeguarding information. Our visit involved looking at 10 care plans, training records, policies and procedures, medication systems and various audits relating to the quality of the service. In addition to this we spoke to 11 people who used the service. We also spoke to the registered manager, two care co-ordinators and four care staff. We contacted other professionals who had regular contact with the service to gain their views.
As part of our inspection, we ask registered providers to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. A PIR was returned to us when we asked.
Updated
15 August 2018
We carried out an inspection of Cheshire County Council domiciliary care on the 18, 20 and 22 June 2018. All visits were announced.
This was the first inspection of this service since it was registered in July 2016.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to predominantly older adults. The service operates a reablement service to people following discharge from hospital for them to gain independence in daily living skills once more. Support packages typically last 6 weeks. The service covers all of the Cheshire West area. At the time of our visit, the service supported approximately 100 people.
A registered manager was 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.
Staff had a good understanding of the types of abuse that could occur and how to raise concerns. Staff were aware of the whistleblowing procedure and how external agencies could be contacted to raise theses.
Recruitment was robust and included checks to ensure that new staff were suitable to support vulnerable people.
Medicines management was robust with any error in medication recording being picked up quickly, managed and reported appropriately.
Staff rotas were in place and systems established to ensure that sufficient staff were available to meet people’s needs. Staff rotas meant that calls were never missed and that both staff and people who used the service were kept safe.
Risk assessments were in place. These were up to date and minimised potential risks in the support they received as well as risks in their home environment.
The registered provider paid attention to the infection control with details for staff available promoting this as well as the provision of personal protective equipment to minimise infection spreading.
Staff received the training they needed to perform their role. Staff received supervision so that their performance could be discussed and developed.
The nutritional needs of people were taken into account with support being provided that sought to increase and maintain people’s independence.
The health needs of people were taken into account with people's health being monitored and responded to where appropriate.
The registered provider had set up effective communication systems within the service to ensure that staff were aware of the progress of individuals as well as changes to positive working practices.
People were treated in a kind, patient and dignified manner.
Staff were aware of how people’s privacy could be promoted.
People’s personal information was kept safe and secure.
The ethos of the agency was to promote independence and for people who used the service to regain life skills to achieve full independence. Care plans were devised in such a way to achieve this and people felt as though they had regained essential life skills in order to live independently.
Information was provided to people in appropriate formats with alternative formats being made available.
Care plans were person centred and geared to achieving independence for people. Appropriate assessments on people’s needs were gained prior to them using the service. Assessments covered all aspects of people’s daily living.
The service did not directly provide assistance with social activities yet the support provided enabled people to re-stablish social links once independent living had been achieved.
A complaints procedure was in Place. No one had needed to make a complaint yet information was available if the need arose.
The service had a registered manager in place. Staff felt supported by the management team.
People who used the service considered that it was well run.
A number of effective audits were in place to measure the quality of the support provided. Medicines audits had picked up the need for further training and support in the administering and recording of medication.
People were asked for their views of the quality of the service through questionnaires and surveys which were reviewed regularly.
The registered provider always informed CQC of any adverse incidents that affected the well being of those who used the service.