26 and 29 May 2015
During a routine inspection
This inspection took place over two days. The first visit was on 26 May 2015 and was unannounced. Another visit was made on 29 May 2015, and on that day the provider knew we would return.
Voyage (DCA) (North 3) is registered to provide personal care to people in their own homes. At the time of our inspection they were 15 people using the service.
We last inspected the service in 07 November 2013. At that inspection we found the service was meeting all the regulations that we inspected.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We saw the provider had followed their recruitment selection policy. Each file held two references from previous employers. We noted all staff had new DBS checks prior to their employment.
The provider had its own whistleblowing scheme, ’See something, say something,’ which outlined what staff needed to do if they witnessed any abuse or harm of a person they were supporting.
We saw risk assessments were present in people’s care records and included poor nutrition, mobility, challenging behaviour and personal hygiene. The risk assessments were specific to the person and identified the risk and the actions needed to be taken to keep the person safe.
Medicines records we viewed supported the safe administration of medicines. Medicines records were up to date and accurate. This included records for the receipt, return, administration and disposal of medicines. We also saw monthly audits were conducted.
We observed assessments of competence in regard to the management of medicines. This included staff answering questions about their practice and being observed administering medication.
We saw records of supervisions and appraisals held, which covered working practices and training needs. The team leader told us, “We aim for six supervisions per year but we do also carry out direct observations in-between.”
We saw people’s care plans clearly described the support they needed with eating and drinking, including any risks associated with their nutrition. Staff were fully aware of any risks around people eating and drinking and understood how they needed to be supported.
People received support from staff to manage their financial affairs. We saw that monthly audits were carried out to make sure their monies were accurately accounted for and used in appropriate ways.
Staff told us they felt supported by the management and received information on changes within the organisation and with the needs of the person they were supporting via face to face team meetings, phone calls, texts and emails.
We saw training and development was up to date. We also saw all new staff had completed a two week induction and a shadowing period where staff read care plans and got to know the person they were going to support.
Staff had a good understanding of their responsibilities under the Mental Capacity Act (2005) (MCA). They were able to tell us when MCA applied to a person. They were also aware of the capacity of people they were supporting and described how decisions were made in people’s ‘best interests.’
The staff were seen to be caring to people and interacted well. We observed staff taking time to talk to people and ensured they demonstrated they understand what people wanted. Staff were friendly and engaged with the whole family.
We asked people who used the service if care workers treated them with respect and dignity. One person told us, “Yes they treat me with respect.” A family member told us, “Staff always ask [my relative] if they want help."
We found care plans were regularly reviewed and were responsive to people’s changing needs. For example one person wished to find employment; staff explored resources in the area and found a suitable placement.
Staff we spoke to were knowledgeable about the people they supported. They were aware of their preferences and interests, as well as their health and support needs. Relative’s confirmed that staff knew their relative well and understood their needs. One relative said, “Staff know [my relative] and what works to support him.”
People were aware of how to raise any complaints or concerns. We saw complaints were dealt with immediately with lessons learnt cascaded to other services within the provider group.
The provider monitored the quality of the service by regularly speaking with people who used the service and relatives to ensure they were happy with the service they received.
People told us the staff supported them to enjoy social activities in the community. One person told us that the staff helped them to go shopping and to go on holiday.
Staff told us they felt supported by the management and received information on changes within the organisation and with the needs of the person they were supporting.
The registered manager undertook a combination of announced and unannounced spot checks to review the quality of the service provided.
The registered manager had been pro-active in submitting statutory notifications to the CQC.