Background to this inspection
Updated
19 January 2019
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.
The inspection took place on 26 and 27 September 2018 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be at the office and able to assist us to arrange home visits.
Inspection site visit activity started on 26 September 2018 and ended on 27 September 2018. It included visiting people in their own home, talking to people and their relatives over the telephone and talking with staff. We visited the office location on both dates to see the manager, staff and office staff; and to review care records and policies and procedures.
The inspection was carried out by one inspector, a bank inspector and two experts by experience, who made the telephone calls to people and their relatives. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed all the information we held about the service. This included notifications the provider had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.
We had requested and received a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed this information during the inspection.
During the inspection we visited seven people who used the service and spoke with two relatives. We spoke with nineteen people and two relatives on the telephone. We also spoke with seven members of staff, as well as the registered manager and the regional manager. Following our inspection, we spoke to one further staff member.
We looked at a range of records during the inspection, these included five people’s care records. We looked at information relating to the management of the service including quality assurance audits and meeting minutes. We also looked at three staff files, the recruitment process, complaints, and staff training and supervision records.
Updated
19 January 2019
Somerset Care (Taunton Deane) is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone using the service receives a regulated activity; 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.
At the time of the inspection 369 people were receiving the regulated activity ‘personal care’.
This inspection was announced and took place on 26 and 27 September 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be at the office and able to assist us to arrange home visits.
There was a registered manager in post. 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.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good.
People told us they felt safe with the care provided and staff who visited them. One person said, “I have never felt anything other than safe. They[staff] are excellent and I look forward to their visits.”
There were sufficient staff to meet people’s needs. People confirmed they had a small team of care workers whom they had got to know. People’s comments on the timing of visits varied. Some people were happy that staff arrived at the agreed time and stayed the agreed length of time. Many commented on staff who stayed longer and did more than they expected. However, some people said they experienced staff arriving either earlier or later than planned. One person said they went to bed at 9pm and got up at 7am which they thought was too long in bed. The registered manager explained they tried to accommodate all time requests but they were open and honest with people at the start of the care package about any timings they could not achieve.
People were protected from harm because the provider had a robust recruitment process and staff received training in how to recognise and report abuse.
People’s medicines were managed safely and people told us they received support to take their medicines correctly and at the right time.
People were supported by staff who knew their needs and understood the importance of delivering effective care and support. Records showed all staff completed the organisations mandatory training and training relevant to the needs of the people. Staff received regular supervision and support from the management team. This was carried out either in one to one or team meetings. People told us that senior staff carried out ‘spot checks.’ This meant the senior staff arrived unannounced to check on staff and ask people what they thought about the team supporting them.
All new staff received an induction and initial training. Before working alone, they were able to shadow more experienced staff and meet the people they would be supporting. Staff told us the training provided was good and that they could also access training specific to people’s needs.
People were supported to have a balanced and nutritious diet. Some people required meals cooked for them and support to eat. At other times, staff supported some people to prepare their own meal and maintain their independence.
People were supported to have maximum choice and control of their lives. Staff helped them in the least restrictive way possible. The policies and systems in the service also reinforced this practice.
People were supported by staff who were very kind and compassionate. People thought staff often went over and above their job roles to ensure their comfort and well-being. People told us how staff had worked in their own time to ensure they were safe. Staff had supported one person to move into a new home. Another person was assisted when they were in hospital and confused. During adverse weather conditions staff had gone above and beyond to ensure people continued to receive a visit.
People told us they could talk with staff if they wished to raise a concern. One person said, “I know who to talk to but I also know I can trust the carers to take anything I am concern about back to the office for the manager to deal with.”
People were supported at the end of their life to have a comfortable pain free death. Care plans showed people’s advance decisions were taken into consideration and acted upon. Staff worked with the community team and local hospice to ensure people could remain in their own home towards the end of their life if that was their wish.
People received care and support that was responsive to their changing needs. Staff had a clear understanding of people’s needs and how to meet them effectively. People were involved in discussing and setting up their care plans.
The service was well run by a registered manager who had the skills and experience needed to run a domiciliary care agency. This meant people received good person-centred care. The registered manager led a team of staff who shared their commitment to providing a good standard of care.
There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. Records showed the service responded to concerns and complaints and learnt from the issues raised. The provider sought people's views and opinions through regular telephone monitoring and an annual survey.