Background to this inspection
Updated
13 October 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.
The first day of the inspection took place on 7 September 2018 was announced. This meant we gave short notice because the agency is small and we needed to ensure there would be someone available in the office. The second day was announced and was spent visiting people in their own home to gain their experiences of using this agency. Both days were completed by one adult social care inspector.
The provider had completed a Provider Information Return (PIR). This is a form we ask the provider to complete at least once a year. It gives us some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted the local authority commissioning team, who has responsibility for monitoring the quality and safety of the service provided to local authority funded people. We received feedback from two health care professionals about their experiences of the service provided.
We spoke with six staff and seven people who used the service. We reviewed three care plans and daily notes as well as other records. These included three staff recruitment files, training records and records relating to quality audits.
Updated
13 October 2018
Quay care is a domiciliary care agency which providers personal care to people in their own homes. This service provides care and support to people living in one ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. It also provides an enabling service to some people which we do not regulate. The service covers Barnstaple and Bideford areas. Currently they provide personal care for up to 28 people.
This agency changed location in July 2017, so this was the first inspection report to be completed in this new location. Under their previous location the service had been rated as good in all five key areas inspected. This inspection took place on 7 and 14 September 2018.
The registered provider/manager and staff showed exceptional caring towards people they provided a service for. People who used the service and professionals who commissioned the service spoke exceptionally highly about the caring ethos and understanding of the service. People and professionals consistently gave really positive feedback including “I would not use any other agency. This is the best. They know what real care is about. They go the extra mile.” And “I only trust this agency. The carers who come to me are very kind and considerate and know how to help me.” Staff were happy to work for the agency and said the caring was extended to them. One said “The manager is so caring. You can go to her about anything. I really feel valued.” The agency made sure staff were cared for by investing in a private healthcare scheme which allowed staff to access free or discounted health care and this include counselling.
Staff were committed to ensuring people were given the best service possible, sometimes in difficult circumstances. All staff were particularly sensitive to times when people needed caring and compassionate support. Respect for privacy and dignity was at the heart of the service’s culture and values. It was embedded in everything that the service and its staff did. An equality, diversity and human rights approach to supporting people’s privacy and dignity was well embedded in the service.
There were sufficient staff with the right skills and understanding of people’s needs and wishes to ensure all visits were completed. People said staff were friendly helpful and arrived on time. Staff could describe way in which they respected people’s dignity and privacy and worked in a way which showed kindness and compassion. People confirmed this was the case. Comments included “The always show respect and ensure dignity. They are super.”
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. People's consent to care and treatment was sought. Staff used the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice. No one was currently under a community DoLS but care plans included detail of how staff should ensure people’s mental capacity was fully considered. Staff were also aware of where relatives was involved and may need to assist in making best interest decisions.
Care and support was person centred and well planned. Staff had good training and support to do their job safely and effectively. The service had invested in electronic care plans which also included electronic daily records. This had helped to improve the overall quality of record keeping and allowed the registered manager and senior team members to access people records remotely if needed.
Risk assessments were in place for each person. These identified the correct action to take to
reduce the risk as much as possible in the least restrictive way. People received their medicines
safely and on time. Accidents and incidents were carefully monitored, analysed and reported upon.
People were kept safe because there were effective staff recruitment and selection processes in place. People received the right care and support from staff who were well trained and competent.
People were assisted to enjoy a wide and varied choice of meals where their care plan included this type of help was required.
Quality assurance processes and audits helped to ensure that the quality of care and support as
well as the environment was closely monitored. This included seeking the views of people and
their relatives.
Further information is in the detailed findings below