23 August 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection team consisted of one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service five days’ notice as we needed to obtain the details of people who used the service to contact by telephone and to ensure the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 19 June 2019 and ended on 27 June 2019. We visited the office location on 25 June 2019 to speak with the registered manager, interview staff and review care records and policies and procedures.
Prior to the inspection we reviewed information we had about the service including statutory notifications which include information the provider is required to send us by law. We also looked at the Provider Information Return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
During the inspection, we spoke with 11 people and four relatives and had correspondence from another two relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, finance director, assistant manager, an office staff member and care staff.
We looked at six people’s care records including their medicine records and daily notes. We viewed a range of records. This included six people’s care records and multiple medicine records. We looked at two staff files in relation to recruitment, staff supervision and training.
Documents relating to the management of the service, complaints and compliments, meeting notes, satisfaction surveys and quality audits were also viewed.
After the inspection – We received correspondence by phone and email from another two relatives and two health professionals who regularly visited the service. We requested further documents and information from the registered manager which was received and looked at as part of the inspection.
23 August 2019
About the service. Doris Jones is a domiciliary care agency proving personal care and support to people living in their own homes. The service supported 71 people at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found.
People and their relatives told us the service provided excellent care and staff went above and beyond their expectation. One person said, “I love [staff member], they cheer me up when I am grumpy, make my house look lovely, nothing gets forgotten, they are brilliant, plump my cushions, get water and rearranges the plants.” A family member told us, “Every aspect of [relative’s] care has been outstanding; punctuality; reliability; professionalism; cheerfulness and kindness. We, as a family, have been immensely impressed and the reward has been my [relative’s] remarkable recovery.” Another said, “[Relative] has the same staff five times per week. They know exactly what they need. I can’t fault them, [name of staff member] knows how to support them and it reassures me.”
The management of the service was exceptional and went above and beyond its remit to provide a well led service. The management team, led by an experienced and passionate registered manager, provided an excellent quality service where people were at the forefront of their care. Staff were highly supported and valued for the energy and enthusiasm they bought to their work.
People and their relatives had trust and confidence in the staff and management which exceeded their expectations. Everyone, without exception, said they would recommend the service to others.
Staff responded to people in a person-centred way, providing individualised care and support. People had received respectful and sensitive end of life care.
People told us they felt very safe with the staff. People appreciated the continuity of care from the same care staff who were punctual and attentive. People were actively encouraged and supported by the staff to take informed risks which increased their independence, autonomy and sense of worth
Safe staff recruitment practices were followed to ensure staff had sound values and the personality and aptitude for carrying out their role. Staff were provided with the skills and knowledge through an effective and individualised training programme to meet their different learning needs.
People received their medicines as prescribed. People confirmed that staff followed infection control procedures and wore gloves and aprons appropriately to prevent the spread of infection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. People were fully involved as partners in their care. Consent was always obtained before care was provided. Staff were exceptionally caring, kind and compassionate and treated people with dignity and respect.
The service worked in collaboration with health and social care professionals and the community to promote joined up care. The service was increasingly proactive in recognising social exclusion and isolation and involved people in the life of the community.
People and their relatives were confident that if they had concerns or complaints, they would be dealt with appropriately. People had information in their preferred format based on their sensory and communication needs.
Systems were in place to monitor the delivery of care through audits, spot checks, staff observational supervision and quality assurance questionnaires. Lessons learned were documented, analysed and shared with the management team and staff to make the service a leading social care provider.
Rating at last inspection. The last rating for this service was Good (published 7 October 2016).
Why we inspected. This was a planned inspection based on the previous rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk