18 July 2018
During a routine inspection
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people. Five people received care and support when we inspected.
The owner or provider of this service was also the manager. There is no requirement for a registered manager to be in post in this situation. 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. We have referred to the owner/manager as the provider throughout this report.
The provider had failed to keep themselves up to date regarding changes to best practice and their responsibilities around meeting the regulations. This meant systems were not always in place in areas such as medicines support, assessment of risks to people needed to be more robust and appropriate training for staff. Also records relating to the recruitment of staff, their supervision and quality assurance checks which had been carried out were not robust.
The provider responded quickly during the inspection to design and implement systems which were appropriate. The provider told us they had sought information from recognised best practice agencies. They had also subscribed to a consultancy for policy support to ensure they remained up to date in the future. This demonstrated their commitment to continuous improvement.
People benefited from a well-managed person-centred service. Staff knew their preferences and likes. Staff treated people with respect and dignity was always maintained. People and their relatives felt the service was well co-ordinated and that they truly were involved in designing and reviewing their care.
Professionals told us the service provided consistent care to people and worked in such a way with other agencies that people’s health was monitored well. This approach meant people did not deteriorate or require further health services on occasions.
Staff morale was positive and they understood their responsibilities. Staff all demonstrated a person-centred attitude to their work. Also, they had a good understanding of how to safeguard people from avoidable harm.
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 felt very confident to approach the provider with any concerns as did staff. The provider was very hands on and frequently delivered support for people. People described the service as a team who worked together for the benefit of people who used the service.
A breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was found during this inspection. This related to good governance. You can see what action we told the provider to take at the end of this report.