Background to this inspection
Updated
6 July 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 was an announced inspection that took place on 3 May 2018. We gave the provider 48 hours’ notice of the inspection. This was because of the service’s smaller size and we needed to be sure the registered manager would be available.
The provider completed a Provider Information Return (PIR) in advance of the inspection. 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.
Before the inspection, we checked notifications made to us by the provider, safeguarding alerts raised about people using the service, and information we held on our database about the service and provider. This included the feedback one person using the service provided to us through surveys we sent out at the end of last year.
The inspection was carried out by one adult social care inspector. There were 12 people receiving a regulated activity from the service, and eight care staff, at the time of our inspection. During the inspection, we received feedback about the service from two people using it, the relatives of two other people, and two community health and social care professionals. We also spoke with three staff members and the registered manager.
During our visit to the office we looked at the care files of four people receiving a personal care service, the personnel files of the four staff members, and other records relating to the care delivery and management of the service such as visit planning records. We were also provided with, on request, a copy of the employee handbook along with some forms the registered manager had updated following our visit.
Updated
6 July 2018
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 adults of all ages, including people with dementia or physical disabilities.
This was the first inspection of this service. Not everyone using the service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which is help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the start of our inspection there were 12 people using the service in this respect.
The service had a registered manager which 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.
There was overall positive feedback about the service, from people using it and their relatives and representatives. Everyone said they would recommend the service to friends and family.
We found people were treated with kindness, respect and compassion. Their privacy, dignity and independence was respected and promoted. Staff were consistently described as ‘caring’.
People's needs were comprehensively assessed to help ensure their specific needs were identified and addressed. The registered manager demonstrated good knowledge of the community resources available in support of meeting people’s needs. The service, therefore, worked well in co-operation with other organisations to deliver effective care and support.
People received personalised care that was responsive to their needs. The service people received was kept under review and adjusted accordingly. People were regularly supported to express their views and be actively involved in making decisions about their care and support.
The service supported people to receive ongoing healthcare support. People were supported to eat and drink enough. Referrals were made if concerns arose.
Consent was obtained before personal care was provided. Where anyone could not make that decision, the service was working towards ensuring an assessment, in line with the principles of the Mental Capacity Act 2005 (MCA), occurred.
There were sufficient numbers of suitable staff to support people. Overall, staff had the skills, knowledge and experience to deliver effective care and support. Staff were supported in their roles, for example, through developmental supervision. The registered manager worked closely with new staff to make sure they were equipped to meet people’s needs before letting them work alone.
We identified areas where the service could not consistently demonstrate safe practices. Whilst there were systems of checking whether people were supported to take medicines as prescribed and that involved staff had sufficient competency, these were not clearly documented. Documents such as risk assessments, care plans, and medicines records were not consistently dated. This had potential to undermine the accuracy of these records when needed, such as for reviews or investigations.
Where the service supported people with medicines management or to move around, risks were not comprehensively assessed to minimise the chances of unsafe support. However, the registered manager provided prompt updates to these assessment process records soon after the inspection visit.
Any safety risks identified for individuals were well managed in practice, such as through making community support referrals or advising the person using the service or their representative. The service also upheld good standards of cleanliness when working with people, which helped prevent infection.
The registered manager demonstrated appropriate leadership values such as through wanting to ensure staff could provide good care when first working with someone new to the service, and pursuing matters in practice to ensure people received safe and responsive care. Systems at the service enabled sustainability and supported continuous learning and improvement.