Background to this inspection
Updated
31 August 2019
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 team consisted of one inspector.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The service also provides personal care to people living in their own houses.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because we wanted to visit people in their homes and we needed support from the registered manager to arrange this. Inspection activity started on 12 August 2019, when we visited people living at home and met with their relatives and staff. We also visited the office location on 13 August 2019.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch (Doncaster). Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 two people who used the service and two relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, the senior operations coordinator, two operations coordinators, and four support workers. We also received feedback from two healthcare professionals.
We reviewed a range of records. This included four people’s care records and two 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
31 August 2019
About the service
A1 Medical and General is a nurse agency providing nursing and care services to private and NHS hospitals, prisons, nursing and care homes. The service is also registered to provide domiciliary care services and supported living services. The office is based in Doncaster.
Not everyone who used the service received personal care. 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. At the time of our inspection the service was supporting two adults who lived together in their own house and one adult and one child who lived at home with their family. These four people were assisted with their personal care needs.
People’s experience of using this service and what we found
People supported told us they felt safe with the staff that supported them. Staff had undertaken safeguarding training which was regularly refreshed. Staff understood their role and responsibility to keep people safe from harm. Recruitment procedures were thorough and robust, with clear evidence of pre-employment checks being carried out. The service managed people's medicines safely and checked people's equipment regularly to ensure it was safe for them to use.
The provider ensured staff completed the training needed to support people well. Staff felt well supported by the management team. Regular supervision, appraisal and team meetings were provided. Staff supported people to eat and drink enough and ensured they received appropriate support with their healthcare needs. 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 supported spoke with the highest praise and regard of the staff that provided support and the office team including the registered manager. People told us staff treated them with dignity and respect and were kind, caring and considerate to them. People received personalised support from staff who knew them well. Staff had built positive relationships with the people they cared for and supported. Staff supported people to retain their independence and to remain involved in planning and reviewing their care. This helped to ensure care was provided in accordance with people's preferences.
Staff supported people to follow their interests and avoid social isolation. They offered people choices and encouraged them to make decisions about their care. No formal complaints had been received by the service.
The registered manager provided staff with leadership and was approachable. Audits and checks continued to be used to drive improvements to the service people received. People's feedback was used to make changes to the service. People, relatives and staff were happy with how the service was being managed. Staff felt well supported by the registered manager and senior staff.
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 31 August 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.