Background to this inspection
Updated
5 December 2018
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.
This comprehensive inspection took place on 1 and 4 October 2018 and it was announced. The provider was given 48 hours’ notice, because we needed to ensure someone was available to facilitate the inspection.
Two inspectors conducted the inspection.
Inspection site visit activity started on 1 October 2018 and ended on 4 October 2018. On 1 October, we visited the office to review the documents associated with the running of the service. On 2 and 3 October we made telephone calls to relatives of people that used the service care staff. On 4 October we met with the person who was using the service.
We used information the provider sent us in the Provider Information Return to help us in our judgements of the service. 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 also reviewed other information we held about the service. This included statutory notifications regarding important events which the provider must tell us about. We contacted commissioners and no information of concern was received about the provider.
During the inspection, we visited one person that received personal care from the service in their own home. We spoke with one relative, two care staff and the registered manager. We viewed the care records of one person using the service and three staff recruitment files. We also viewed records relating to the management and quality monitoring of the service, such as audits and feedback.
Updated
5 December 2018
Toller House is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults or adults with disabilities.
Not everyone using Toller House received the regulated activity; the Care Quality Commission (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 our inspection, one person was receiving personal care.
This inspection took place on the 1 and 4 October 2018. This was the first comprehensive inspection for the service since it registered with the CQC in October 2017.
There provider is the 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.
Staff received safeguarding training so they knew how to recognise the signs and symptoms of abuse and how to report any concerns of abuse. Risk management plans were in place to protect and promote people’s safety. The staffing arrangements were suitable to keep people safe. The staff recruitment practices ensured staff were suitable to work with people. Staff followed infection control procedures to reduce the risks of spreading infection or illness.
The provider understood their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016. The AIS is a framework that makes it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information they are given.
Staff received induction training when they first started to work at the service. On-going refresher training ensured staff were able to provide care and support for people following current best practice guidance. Staff supervision systems ensured that staff received regular one to one supervision and appraisal of their performance.
Staff were able to support people to eat and drink sufficient amounts to maintain a varied and balanced diet. Records about people’s health requirements were documented. Staff were able to support people to access health appointments if required.
People were encouraged to be involved in decisions about their care and support. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care. People had their privacy, dignity and confidentiality maintained at all times. The provider had a complaints procedure in place to manage and respond to complaints.
People had their diverse needs assessed, they had positive relationships with staff and received care in line with best practice meeting people’s personal preferences. Staff consistently provided people with respectful and compassionate care.
The service had a positive ethos and an open culture. The registered manager who was also the provider was a visible role model in the service. People told us that they had confidence in the registered manager’s ability to provide consistently high quality managerial oversight and leadership.