Background to this inspection
Updated
5 June 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 between the 10 and 14 May 2018 and was announced. The inspection was undertaken by one inspector and an assistant inspector. We gave the provider 48 hours' notice as we needed to be sure they were in. This was also because some of the people using the service could not consent to phone calls or a home visit from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this.
Before the inspection the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least annually. This provides us with information about the service, what the service does well and improvements they plan to make. We used this information to assist us with the planning of this inspection. We also looked at other information we held about the service. This included information from notifications the provider sent to us. A notification is information about important events which the provider is required to send to us such as incidents or allegations of harm.
We also sent out survey questionnaires to people, relatives, healthcare professionals and staff. We used responses to these questionnaires to help make a judgement about the quality of service people received.
Prior to our inspection we contacted the local safeguarding authority to ask them about their views of the service. This organisation's views helped us to plan our inspection.
On the 10 May 2018 we visited the provider's office and we spoke with the nominated individual (This is the person who has overall responsibility for supervising the management of the regulated activity, and ensuring the quality of the service provided), the registered manager, three office based staff with management roles and one care staff member. On 11 May 2018 we spoke with five people and one relative by telephone. On 14 May 2018 we spoke with a further three relatives, two care staff and a social worker.
We looked at care documentation for four people using the service and their medicines' administration records. We also looked at two staff files, staff training and supervision planning records and other records relating to the management of the service. These included records associated with audit and quality assurance, accidents and incidents, compliments and complaints.
Updated
5 June 2018
Lucmont Limited t/a Home Instead Senior Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to older people, people living with dementia and people with mental health needs. Not everyone using Lucmont Limited t/a Home Instead Senior Care received a regulated activity; the Care Quality Commission (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.
This inspection was carried out between 10 and 14 May 2018 and was an announced inspection. This is the first inspection of this service under its current registration. At the time of our inspection there were 96 people using the service.
The service had a registered manager. 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.
People received a safe service. Staff had a good understanding of safeguarding procedures and keeping people safe. The registered manager’s response to accidents and incidents helped reduce the potential for any recurrence. The staff recruitment process helped ensure that the necessary checks were completed before new staff commenced their employment. There was a sufficient number of staff in post who were provided with the training and skills they needed to provide people with safe care and support. People's medicines were administered and managed safely.
People received an effective service that took account of their independence. Staff knew how to promote people’s independence. People were supported to make decisions that benefitted their wellbeing by staff who knew what decisions each person could make. People's care plans included sufficient detail of their assessed needs and the amount of support they required from staff. Risks to people were identified, and plans were put into place to promote their safety in a way which gave people freedom of choice.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People benefitted from the support and care that trained and skilled staff provided. This helped to promote people's safety and independence. Staff were regularly reminded of their responsibilities in meeting each person’s individual needs. The registered manager used information from regular spot checks of staff’s performance to help staff to maintain and improve their skills. Staff enabled people to access community or other primary health care services. People were supported to eat and drink sufficient quantities of food and fluid.
People received a caring service that was provided with compassion. This was by staff who ensured people’s privacy and dignity was promoted. Staff respected people’s rights to be cared for in an unhurried and considerate manner. People's independence was promoted by staff who encouraged people to make their own decisions about their care. People who needed advocacy had this in place and this helped ensure people’s views were considered and acted upon.
People received a responsive service that helped them to have their needs met in a person centred way. Suggestions and concerns were acted upon before they became a complaint. Technology was used to help people to receive care that was timely. Systems were in place to support people to have a dignified death.
People received a well-led service which they were involved in developing. Their views were listened to, considered and acted upon. Staff meetings and communication systems including a newsletter helped staff to receive updates about the service and people who used it. Staff were provided with regular updates to their training with opportunities to develop their skills. The registered manager promoted openness within the staff team to get the best out of them. Staff were supported staff in their role by other more experienced staff members as well as having their views listened to. Appropriate support arrangements were in place for each staff member. Quality assurance, audit and governance systems were effective in driving improvements.
Further information is in the detailed findings below.