Background to this inspection
Updated
26 April 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
An inspector and an expert by experience carried out the inspection. 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:
Home Instead – Luton & Central Bedfordshire is a domiciliary care agency. It provides care and support to people living in their own houses, flats or specialist housing.
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:
We gave the service 48 hours’ notice of the inspection site visit because the manager is often out of the office supporting staff. We needed to be sure they would be in to support the inspection.
Inspection activity started on 14 March 2019 and ended on 29 March 2019. We visited the office location on 19 March 2019 to see the manager and office staff; and to review care records and policies and procedures. During this, we spoke with the registered manager, the manager, a care coordinator, a client management coordinator, a caregiver liaison support, an auditor, and two care staff.
What we did:
Before the inspection, we looked at information we held about the service including notifications. A notification is information about events that registered persons are required to tell us about. We checked the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.
During the inspection, we looked at various information including:
¿ Care records for four people and medicines charts.
¿ Records of accidents and incidents; compliments and complaints; audits; surveys.
¿ Three staff files to check the provider's staff recruitment, training and supervision processes.
¿ Some of the provider’s policies and procedures.
We spoke by telephone with 10 people using the service, nine relatives of other people and two staff.
Updated
26 April 2019
About the service:
Home Instead Senior Care – Luton and Central Bedfordshire is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing in the community. It provides a service to adults. At the time of the inspection, 47 people were being supported by the service.
Not everyone using a domiciliary care agency receives regulated activity; 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.
People’s experience of using this service:
People’s comments about the quality of the service varied. Most people were happy with how staff supported them, found staff to be skilled, caring and responsive to their needs. However, some people, relatives and staff did not find the provider to be always responsive to concerns raised about the service. They said their feedback was not always used to make consistent improvements. These comments meant that we rated Well-led ‘requires improvements’, but there were no breaches of regulations.
People were protected from harm by staff who had been trained and confident in recognising and reporting concerns. Potential risks to people health and wellbeing were assessed and minimised. There were enough staff to ensure people’s needs were met safely. People were supported well to manage their medicines because staff had been trained to do so safely. Staff followed effective processes to prevent the spread of infection.
Staff had been trained and had the right skills to meet people's needs effectively. Staff were well supported and had information to meet people’s assessed needs. Where required, staff supported people to have enough to eat and drink. Staff supported people to access healthcare services when required. This helped people to maintain their health and well-being.
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 were involved in making decisions about their care and support. People and their relatives were involved in planning and reviewing care plans. People told us staff who supported them were caring and friendly. Staff respected and promoted people’s privacy, dignity and independence.
Information in people's care plans supported staff to deliver person-centred care and in a way that met people’s needs. The registered manager worked in partnership with other professionals to ensure that people received care that met their needs. There was a system to ensure people’s complaints were recorded, investigated, and acted upon to reduce the risk of recurrence. The service did not always support people at the end of their lives and therefore this information was not included in people’s care plans. However, the registered manager said they will include people’s wishes in their care plans as soon as possible.
Audits and quality monitoring checks were carried out regularly to make the required improvements quickly. The provider had systems to enable people to provide feedback about their experiences of the service. The registered manager said they will further improve these systems to ensure people had more opportunities to provide feedback.
Rating at last inspection:
The service was rated 'requires improvement' when we last inspected it. That report was published in March 2018.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.