Background to this inspection
Updated
13 March 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector.
Service and service type:
Two Hoots is a domiciliary care agency, set up to provide care to people in their own home.
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 the service 72 hours’ notice of the inspection. This was as this is a small service and we needed to ensure someone would be in. We also gave notice, so that the registered manager could check with the person to see if they would be happy to speak with us.
We visited the service offices and the person's own home, which are located on the same site, on 26 February 2019.
What we did:
Before the inspection
• We reviewed notifications we received from the service in line with their legal obligations.
• We looked at information the provider had sent us about the service in the Provider Information Return (PIR).
During the inspection
• We looked at the care records belonging to the one person using the service.
• We reviewed records of safeguarding investigations, accidents, incidents and complaints.
• We discussed quality assurance processes and checked recruitment, supervision and training information.
• We spoke with the person who used the service and observed interactions between them and their staff.
• We spoke with two care staff members, the operations manager and the registered manager.
Updated
13 March 2019
About the service:
Two Hoots is a domiciliary care agency, set up to provide care to people in their own home. At the time of inspection, there was one person using the service.
People’s experience of using this service:
The person using the service felt safe and had confidence in the provider to act on any concerns. The person told us, “I feel safe now. I have no worries. I have people around me that actually care about me and I get on well with all my staff.” The person and provider were honest about the fact that in the previous year there had been times when the care had not been good. The registered manager had taken action to rectify this, which included employing an entirely new staff team and reviewing how the company worked. We understood from conversations that in many respects this meant the service was starting anew and things were still settling.
The registered manager and staff worked closely with the person to involve them in changes and decisions over how their care was provided. This included involving the person in recruitment and staffing decisions. It was clear that the previous year had been difficult and we considered some areas of improvement with the registered manager, to ensure lessons were learned to prevent reoccurrence of events. The registered manager and operations manager were engaged with our inspection and open to feedback, to ensure improvements would be made. This included aspects of governance, record-keeping and quality assurance that needed to be developed to underpin safe, good care. Our judgements reflect what we found at the time of our inspection and the experience of the care the person had in their own home at the time of our visit, which was good.
Recruitment was ongoing to rebuild the person’s staff team, however they felt there were enough staff to meet their needs. Safeguarding and risk management processes were in place, which staff were aware of and in which the person was involved. The person checked their own medicines and took them with support from staff.
The service focussed on good outcomes for the person and a promotion of their independence. The person and staff spoke warmly about each other and we observed caring, encouraging and respectful interactions. Training for the new staff was being rebuilt, but the registered manager was at hand to show staff what they needed to learn. Comprehensive care plans were in place to provide staff with person-centred knowledge. Care was personalised and responsive to individual needs.
The service continued to meet the characteristics of Good in most areas. More information is in the full report, which is also available on our website at www.cqc.org.uk.
Rating at last inspection: Good (22 September 2016)
Why we inspected:
This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating.
Follow up:
We will follow up on this inspection through ongoing monitoring of the service, through conversations and checking relevant notifications