31 October 2018
During a routine inspection
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection six people were using the service. Not everyone using the service receives the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
The service was not required to have a registered manager. This was because the service is owned by an individual provider who also manages the service. Registered providers 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 was aware of their registration responsibilities and submitted statutory notifications about key events that occurred at the service as required.
People said they felt safe with staff. Staff were trained to safeguard people from the risk of abuse and knew how to report any safeguarding concerns to the appropriate person and agencies. The provider had systems to assess and identify risks posed to people. Staff had a good understanding of the support people needed to promote their independence and freedom yet minimise any identified risks to them. Staff followed good practice to minimise risks from poor hygiene and cleanliness when providing personal care. Incidents involving people were reported promptly by staff for the provider to review and take action where required.
People contributed to the planning of their care and support. People’s needs were assessed to determine the level of support they required. The provider developed a care plan for them so that staff had relevant information about the care and support people required at each planned visit. Staff received relevant training to help them meet people’s needs. They were supported in their role to continuously improve their working practices. People’s care and support was reviewed with them by the provider, to ensure this was continuing to meet their needs.
People said staff were able to meet their needs. Staff were kind and caring and provided people with support that was dignified, respectful and which maintained their privacy always. Staff supported people to be as independent as they could be.
There were enough staff to meet people’s needs. The provider monitored staff turned up on time for scheduled visits and took action when any concerns about this were raised. The provider ensured wherever possible, people using the service received support from the same staff. People could specify who they preferred to be supported by. The provider carried out checks of staff’s suitability to support people as part of their recruitment arrangements.
Staff documented the support provided to people which kept others involved in people’s care up to date and informed. They monitored people’s general health and wellbeing and when they had concerns about this they took prompt action so that support could be sought from the relevant healthcare professionals. Staff worked closely with other healthcare professionals to ensure a joined-up approach to the support people received.
People and their relatives were satisfied with the care and support they received. People and staff spoke positively about the provider and described them as accessible and supportive. The provider had aims and standards for the service and communicated to people what they should expect from staff and the service in terms of quality of care. People knew how to make a complaint if needed and the provider had arrangements in place to deal with these.
The provider sought people’s and staff’s views about the quality of care and support provided and how this could be improved. They used this information along with other checks of the service to monitor and review the quality and safety of the support provided. Any shortfalls or gaps identified through these checks were addressed promptly.
The provider made improvements when these were required to enhance the quality of the service. The provider had recently recruited a care coordinator. This meant the provider could use their time more productively on the overall management of the service to ensure that key standards were being met. We found the provider was responsive and made immediate changes and improvements based on our feedback during the inspection. This included improving information for staff about identified risks to people, checks on staff references and fitness to work, introducing formal one to one meetings for staff and updating the complaints policy and procedure and service user guide so that this contained accurate and more meaningful information for people.
The provider worked in partnership with other agencies to develop and improve the delivery of care to people. They worked collaboratively with local authorities funding people’s care, so they were kept up to date and well informed about people’s care and support needs.
We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff received training in the MCA and were aware of their responsibilities in relation to the Act. Records showed people’s capacity to make decisions about aspects of their care was considered when planning their support.