9 October 2018
During a routine inspection
This service is a domiciliary care agency. It provides personal care to people living in their own homes with an acquired brain injury. This service also provides care and support to people living in a 'supported living' setting, so they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.
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 the inspection the service supported 19 people. Eleven people required support with 'personal care' in their own home and eight people were receiving care and support in a three separate 'supported living' settings.
No one with a learning disability was using the service. Therefore, we have not assessed whether the care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance at this inspection. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. We will look at this aspect of the service at our next inspection, if applicable.
There was a registered manager in post at the time of our inspection, but was moving to a new post within the company. A new manager had started on 9 October 2018 who was going to registered with CQC. The registered manager had recently introduced field care supervisors to support staff members who provided care and support for people. 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.
Medicines management systems were in place to support people with their medicines. Minor concerns were noted with how staff recorded information when they had supported someone with their medicines and audits had not picked up on these issues. This was being addressed by the registered manager.
A quality assurance system was in place to make sure the registered manager had an overview of the service provision. However, the medication audit was not robust. The operations manager said a satisfaction survey was due to be sent out soon to people who used the service, relatives and staff.
People told us they felt safe with staff and the care and support they received. Staff understood how to recognise abuse and there were appropriate systems in place to protect people from the risk of harm. Staff had access to personal protective equipment and had completed infection control training.
Staffing levels were appropriate to effectively meet people’s care and support needs. People felt staff had the skills to do their job. People were provided with care and support by staff who had received appropriate and training. The registered manager told us they were a little behind with staff supervisions but a structured supervision scheduled had recently been implemented. Recruitment processes and checks were in place and followed. Staff told us they had received induction and on-going support where needed.
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. Some people had mental capacity assessments in their support plans.
People were supported to access a wide range of healthcare professionals when needed and where identified in their support plan, people received support with eating and drinking.
People said they were happy with the staff who were kind and caring and they were treated with dignity and respect. Staff treated people with respect and took steps to maintain their privacy, dignity and independence. People’s care and support needs were assessed and support plans identified how care and support should be delivered. People choose how they spent their time and what activities and outings they wished to take part in.
The service did not currently support anyone who was approaching the end of their life.
People and staff were complimentary about the registered manager. They said they were approachable and listened. A complaints procedure was in place which enabled people to raise any concerns or complaints about the care or support they received.