Background to this inspection
Updated
21 April 2020
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
The inspection was carried out by one inspector.
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 did not have a manager registered with CQC. A registered manager is a person who is legally responsible for how the service is run and for the quality and safety of the care provided. It is a requirement of the provider’s registration that they have a registered manager. The manager running the service had applied to register with CQC.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 03 March 2020 and ended on 05 March 2020. We visited the office location on 04 and 05 March 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and 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 seven people who used the service and three relatives about their experience of the care provided (we carried out home visits to three people). We spoke with seven members of staff including the manager, care co-ordinator, care field supervisor, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included seven people’s care records and five people’s medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
21 April 2020
About the service
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger and older adults with various needs including, people with physical disabilities, sensory impairments, and dementia. At the time of this inspection 42 people were using the service. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service
Governance systems required improvement. Enough improvement had not been since the last inspection and audit systems were still not robust. Audit processes did not look at the quality of records and did not identify the issues we found during the inspection.
Improvement was required with medication administration records (MARs). Some MARs contained missing information and the provider’s medicine policy was not always adhered to.
People were protected from the risks of abuse and harm and people said they trusted staff to keep them safe. Staff had received training in safeguarding adults and understood how to recognise signs of abuse. Staff knew how to report any concerns.
People told us the care workers arrived on time to deliver their care and they received regular care workers. An electronic system was used to organise rotas and each person’s visits (where requested) were either emailed or posted to them, so people were aware of which care worker was due to visit.
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 had a caring approach to their work and they demonstrated kindness and respect when speaking about the people they supported. People told us staff were kind, courteous and sensitive.
Equality and diversity was respected by the service and staff. The provider promoted equality and diversity. Celebration of ‘pride’ month took place for the lesbian, gay, bisexual, and transgender (LGBTQ) group. International women’s day was celebrated with activities and fund raising took place for charities supporting women’s rights.
Detailed assessments and care plans had been completed which reflected the person’s needs and preferences. The care plans provided guidance for staff about how to support people. The use of technology and electronic mobile applications allowed updates to people’s needs to be quickly identified and actioned. Live links to mobile devices ensured people, their relatives and staff could access information at any time.
Staff felt valued and supported by the management team. Staff were recognised and awarded for their work. Employee of the month initiatives and ‘wow’ cards to highlight good work were in place. Staff recognition was also published in the provider’s monthly newsletters.
People and their relatives we spoke with told us they would recommend the service.
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 requires improvement (published 20 February 2019).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.