Background to this inspection
Updated
9 February 2019
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 8 January 2019 and was announced.
We gave the service 4 days’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
The inspection was undertaken by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed the information that we held about the service, this included notifications. Notifications are information that provider is required by law to tell us about. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
Inspection site visit activity started on 8 January 2019 and ended on the same day. It included telephone calls to people. We visited the office location on 8 January 2019 to see the manager and speak to staff; and to review care records relating to three people, four staff recruitment files, policies and procedures and other records relating to the running of the service. We spoke with four people and three relatives of people receiving a service on the telephone. We spoke with the provider, the deputy manager and three care staff. We also spoke with three health and social care professionals.
Updated
9 February 2019
This inspection took place on 8 January 2019 and was announced.
Saltimmary Homecare Professionals 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 older adults and people living with dementia.
Not everyone using Saltimmary Homecare Professionals receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the service was providing the regulated activity of personal care support to 9 people.
The service did not have a registered manager. The service is not required to have registered manager as the provider is registered as an individual. The provider retains the responsibility to be the manager as well, being a ‘registered person’. 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.
Following the last inspection, on 26 September 2017, we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, responsive and well-led to at least good. At this inspection we found that improvements had been made and the provider was meeting the regulations. Recruitment practices had been reviewed and improved. The training completed by staff had been reviewed, to ensure staff had practical instruction with moving and handing, before supporting people. Practices when staff were supporting people with medicines had been reviewed to ensure the provider had oversight and had taken action when recording was not consistent. Quality assurance and monitoring systems had been put in place to support the provider to have oversight and understanding of the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the practices and systems in the service did not always support this practice.
We have made a recommendation about knowledge and understanding of the Mental Capacity Act.
People felt safe. Staff knew how to report any concerns about people’s safety. Lessons were learnt when things went wrong. The provider understood their duties to report and share information.
People were treated with kindness, respect and compassion. The provider supported staff to develop relationships with people, giving them time to provide care in a personal and compassionate way. People were supported by staff with shared interests. One person told us, “They [staff] are all caring and kind to me.” Another said, “They are always caring and listen to me. I couldn’t be more pleased with them all.”
People’s independence was promoted. People’s privacy and dignity were respected. Confidentiality was protected, with staff’s understanding and records kept securely.
People knew how to raise complaints, and were confident to do so. People and staff were involved in evaluating the service. The provider took action when opportunities for improvement were highlighted.
There were enough staff to meet people’s needs. People were visited by the same staff, wherever possible, to give them continuity. Staff were trained to give them the right skills to support people. The provider met with staff regularly, for staff meetings or individual supervision. Safe recruitment practices were followed when taking on new staff. Staff new to the service were supported with induction which included shadowing established staff.
Risks to people were assessed and individually planned for. Risks about infection control and lone working were assessed and mitigated. People were supported to take their prescribed medicines safely, as required. Some people had assistance with preparing food and drink.
People’s needs were assessed and planned for. People and their relatives were involved in the assessment and planning so that their care was provided in a personalised way. People were supported at the end of their lives. Staff worked with other agencies to ensure people had the right support.
Staff worked well together, with regular communication. Staff also worked in partnership with healthcare professionals and other agencies. There were links between the service and the local community.
Quality assurance systems ensured that the provider had oversight of the service provided. Learning from these checks were shared with the staff team to improve the service.