After the inspection we made a compliance action requiring the provider to have systems in place that ensured people's care records were accurate. Following the inspection the provider sent us an action plan telling us what steps they were going to take to make the necessary improvements.
During this inspection we found that improvements had been made. The care records were accurate and up to date.
' Is the service safe?
' Is the service caring?
' Is the service effective?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. The summary is based on speaking with people using the service, speaking with staff who support them, speaking with management and from looking at records.
Is the service safe?
We spoke with three people using the service who told us they felt safe with the staff and felt the staff knew what they were doing.
We saw that systems were in place to help prevent and control infection within people's homes. The documents we looked at showed that staff were appropriately trained in infection control procedures.
Management visited people using the service on a regular basis to make sure they were satisfied with the care and support provided.
Safe systems were in place for the management of medicines and people told us they received their medicines safely.
Is the service caring?
People we spoke with were complimentary about the staff. Some of their comments were; 'The staff are all very nice, very helpful and they seem to know what they are doing' and 'They are very good, very respectful and I feel safe with them'.
Is the service effective?
Arrangements were in place to ensure that people using the service were cared for by staff who were properly trained, supported and supervised.
People we spoke with told us that they felt their needs were being met. We were told that staff from the agency came out to see them before they started receiving care and support and discussed their needs and preferences. The care records however showed little evidence of a discussion about the person's needs, choices or preferences. This meant it was not possible to know if the care records clearly reflected people's wishes.
People's care records contained enough information to show how people were to be supported and cared for. We did see that the care records were not always updated when there had been a change in the way care was being provided.
We have asked the provider to tell us how they will make improvements and meet the requirements of the law to ensure there is up to date information in relation to people's care records.
Is the service responsive?
A discussion with one of the people using the service showed that when they felt their needs had changed and they needed more support, one of the agency staff went out to visit them to discuss the further support required. This showed that the agency responded in a timely way to any changes in a person's needs or requirements.
People we spoke with told us that they had a copy of the complaints procedure in their home and knew who to speak to if necessary. They told us they felt confident that if they made a complaint it would be dealt with properly. We saw that the provider had a clear procedure in place with regards to responding to any complaints and concerns.
Is the service well led?
There were a number of quality assurance systems in place to ensure people were cared for safely, although the auditing of some care records was not as robust as it should have been.
Management carried out regular staff observation checks to make sure that staff provided safe care and support that met people's needs.
The computer system in place alerted management when some aspects of the running of the business were ready for reviewing.
All staff were issued with an employee handbook. This enabled them to have easy access to the clinical policies and procedures and to the documents that were in place to help protect their safety and wellbeing, such as whistleblowing.
People's care records contained enough information to show how they were to be supported and cared for. The people we spoke with were very complimentary about the staff and about the care and support provided. Some of the comments were, 'They certainly look after me well' and 'They are all very nice and very good'.
Systems were in place to help protect people by ensuring that staff were suitably trained in the safeguarding of vulnerable people. One of the people we spoke with told us, 'Yes I trust the staff and I feel safe'.
Arrangements were in place to ensure that people using the service were cared for by staff that were safely recruited.
The systems in place to monitor the service provided helped protect people against the risks of inappropriate or unsafe care.