18 July 2018
During a routine inspection
This comprehensive inspection took place on 18 July 2018 and was announced. This was the first inspection of this service since it was registered on 25 August 2017.
Not everyone using this service receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, which means help with tasks related to personal hygiene and eating. Where people receive personal care we also consider any wider social care provided. At the time of our inspection the service supported five people with their personal care needs.
The service did not have a registered manager. 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. The provider had recruited to the role of registered manager and the person was in the process of obtaining CQC registration. A registered manager from another branch was providing cover as acting manager.
Quality systems and audits were in place to monitor the service people received, but did not always effectively identify areas for improvement. We found that some quality assurance processes were not undertaken as scheduled. The provider recognised these areas needed to be addressed and the acting manager had a support plan in place and we saw evidence this was being actioned. While these improvements were being made, time was now needed to fully embed the new systems and processes to sustain improvement. We did not find these inconsistencies had impacted on the safety of people, but is an area of practice that needs to improve.
People were protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.
Good systems and processes to keep people safe were maintained. One person told us, “They make me feel safe, they know what they’re doing.” Risks to people had been identified and staff understood people well and how to manage risks to help ensure people were safe. People were supported to receive their medicines safely by staff that were trained in administering medicines. The provider had a lone worker policy to ensure staff were kept safe in the community.
Staff were employed using appropriate recruitment practices. Staff received an induction and received essential training. When the acting manager identified additional training needs, we saw that this was put in place. Staff told us they felt well supported by the acting manager and the wider management team. One member of staff told us, “Its lovely to work here, I’ve been very happy here.” There were enough staff to cover all care visits and people said that they had enough time with care staff and their calls were never missed.
People were supported to maintain their health and had assistance to access health care services when they needed to. Staff supported people by arranging healthcare appointments for them. A community health professional told us that when carers had concerns about people’s health they were contacted appropriately. Staff understood the principles of the Mental Capacity Act [2005] and where people lacked capacity we saw appropriate assessments were made and were decision specific.
People told us the staff were kind and caring and they were happy with the service they received. People were involved in developing their care plans. One member of staff told us, “We look after residents well, I think people will say they get good care.” Staff supported people to have choices over food and drink and supported them to remain as independent as possible in their home.
People were confident their concerns would be responded to and knew how to raise any concerns and make complaints if needed. People were supported to pursue activities and interests that were important to them. People told us the service was improving under new management. Staff told us they felt supported by the management team and there were clear lines of responsibility and accountability. Staff achievement was recognised and encouraged. One person told us, “We have nothing negative to say, it’s all been positive. Since living here I’m happy with the care and support, everyone is kind and caring in my eyes.”
Further information is in the detailed findings below.