A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence supporting our summary please read our full report.
This is a summary of what we found:
Is the service safe?
People spoke positively about the care they received and about their care workers. People said they knew who to speak to if they had any worries or concerns and were confident that action would be taken if they raised any issues. One person said 'I always feel safe with the carers.'
People told us that they felt their rights and dignity were always respected.
Effective management systems were not always in place to make sure the manager and staff learned from events such as analysing accidents and incidents, complaints, concerns and investigations. The service had completed individual comprehensive risk assessments for the environment and people's physical and mental health. However the agency had no monitoring systems in place to check and ensure that the people they provided care to were safe.
People we spoke with confirmed they received their medication as prescribed. Some people told us that they could administer their own medication safely with minimal support from staff. However there were no audits being carried out to check that people received their medication safely.
Is the service effective?
People told us that carers asked them about everything and sought their permission. People's files we looked at contained consent from people before they received a service.
People we spoke with confirmed they had a care plan in their home, which was followed by carers when they visited. People did not know if their care plans were up to date and reflected their current needs. One person said 'They (carers) are all very good indeed.'
Some staff had not received training to meet the needs of the people they support in the community. This was because training for some staff including mandatory training such as first aid, moving and handling and safeguarding was out of date.This meant that people could potentially be put at risk because staff did not have appropriate training.
Staff we spoke with told us they felt supported by the management from the agency.
Is the service caring?
People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. We spoke with seven people who were using the service and two relatives who had relatives using the service.
Everyone we spoke with told us they were satisfied with the care they received and spoke positively about individual care workers. People described carers as being 'professional and very kind'. People said 'They (carers) are all really, really nice. They (carers) are helpful, understanding and caring.' Another person told us, "I can't say a bad word about them. I like to have a joke with them. They do everything that I ask them to do' and 'The carers are all very pleasant and amicable, friendly and kind.'
Is the service responsive?
People told us their care workers generally arrived on time and they stayed for the correct length of time that had been agreed. When carers were running late people told us that they would phone to let them know.
People told us if they had any problems they would contact the senior person in charge or the manager who would make sure any issues were sorted out. People said whenever possible they were kept informed about any changes to the usual care workers who attended to them.
People we spoke with told us they knew how to make a complaint if they were unhappy. Everyone we spoke with told us they would ring the agency office. People also told us that complaints would be investigated and action taken as necessary. One person said 'I would ring the office and X would sort it out.'
People were not given the opportunity to share their views about the agency.
Is the service well-led?
People we spoke with told us that the service they received from the agency was good and the carers were 'very caring'.
We saw that there was not an effective and robust quality assurance system in place which meant that the service was learning from any audits to make continuous improvements at the service.
Effective management systems were not always in place to promote and safeguard people's safety and welfare. This was because the agency did not regularly support the staff team through regular one to one supervisions, appraisals, staff meetings and the necessary training of staff to ensure current and best practice was being followed. The registered manager of the service was absent and CQC had not been notified of this absence as required. We have asked for further information about this issue.