19 June 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 checked 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 was carried out by one inspector. We visited the agency office on 6 March 2019 and we telephoned people on 14 March to gain their views about the service.
Service and service type:
This service is a domiciliary care agency that provides care services to older people and younger adults people in their own homes. Not everyone using the service receives a regulated activity of 'personal care.' CQC only inspects the service being received by people provided with ‘personal care’.
The service did not have a registered manager in post. It is a condition of the providers registration that a registered manager is registered with the Care Quality Commission and they with the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided. A manager oversaw the day to day operations of the service and the registered provider was in the process of registering a manager.
What we did:
Before visiting the service, we looked at previous inspection reports and information sent to the Care Quality Commission (CQC) through notifications. Notifications are information we receive when a significant event happens, like a death or a serious injury. We also looked at information sent to us by the manager through the Provider Information Return (PIR). The PIR contains 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 four people's care plans. We also looked at a variety of different sources of information relating to people, such as; risk assessments. In addition, we looked at; feedback surveys, staff rotas, training records, recruitment files, medicine administration records, complaints and accident logs.
We gathered people’s and their relatives experiences of the service by telephoning them and sending them questionnaires during the inspection process. We received feedback from four people. We also spoke with the manager and two members of staff. The four external health care professionals we contacted did not feedback any concerns about the service.
19 June 2019
About the service: This service provides personal care to people living at home. This included older people and younger adults some of whom were living with dementia, learning disabilities and physical disabilities. There were ten people receiving personal care when we inspected.
People’s experience of using this service:
People and their relatives commented. “We are happy with the safety of the service.” “We are happy staff are sufficiently trained.” “The staff are all very caring towards my relative, he is very happy with them.”
People told us they felt safe with staff. Staff had been trained to administer medicines safely. People told us that staff were caring towards them.
People’s needs were assessed. Care plans were in place. The care plans were consistently reviewed. People’s rights and their dignity and privacy were respected. The care offered was inclusive and based on policies about Equality, Diversity and Human Rights.
Staff were not routinely required to assist people with health care monitoring or preparing food and drinks because people did this themselves or lived with others who did this for them. Complaints made by people or their relatives were taken seriously and thoroughly investigated.
People told us they were listened to by the management of the service. Background checks were made on new staff. Staff were trained and supervised to maintain the standards of care. Staff were deployed in the right numbers to meet people's needs and choices.
Health and safety policies and management plans were implemented by staff to protect people from harm. Systems were in place so that incidents and accidents were investigated to reduce the risks of these happening again. Staff received guidance about infection control and protective equipment like disposable gloves to minimise the risks from the spread of infection.
People, their relatives and staff had the opportunity to share their views about the service. The service could continue to run in the event of emergencies arising so that people’s care would continue. Staff were not providing end of life care at the time of this inspection.
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.
Rating at last inspection: At our last inspection on 24 November 2017, (The last inspection report was published on 07 February 2018), we gave the service a ‘Requires improvement’ rating because there was no registered manager in post. At this inspection the provider was in the process of registering a manager, but they were not yet registered. Not having a registered manager in post was a limiter of the rating of the Well Led key question, therefore the 'is it well led' key question is rated as ‘Requires improvement.’ the overall rating is 'Good.'
Why we inspected:
This was a comprehensive inspection scheduled based on the previous rating.
We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves their rating to at least Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk