Background to this inspection
Updated
13 November 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. 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.
Inspection team
The inspection was completed by one inspector.
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
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed permission to telephone people.
Inspection activity started on 16 October 2019 and ended on 17 October. We visited the office location on 17 October 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We contacted the local authority to seek their views of the service, but they did not commission with them. We reviewed our records in terms of notifications of events. This is information the provider must send us by law. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and two people’s relatives. We also spoke with two members of staff and the registered manager. We looked at people’s care records, a medication chart, daily notes, staff recruitment checks and other documents which related to the management of the service.
After the inspection
We sought confirmation about the actions the registered manager had taken after we had identified some concerns about staff recruitment.
Updated
13 November 2019
About the service
Shekhina Care is a home care agency who was providing personal care to three people at the time of this inspection.
People’s experience of using this service and what we found
We identified some shortfalls with staff recruitment checks. This had the potential to undermine people’s safety. Certain checks had not been completed, this is important especially as people are often on their own, when in the care of staff.
The registered manager and nominated individual (the nominated individual is responsible for supervising the management of the service on behalf of the provider) did not always have effective systems in place to identify and make improvements to the service. Their quality monitoring systems had not identified the shortfalls which we had found.
People told us they felt safe with staff and the registered manager. People had risk assessments in place. Staff reminded people to take their medicines and there was a system for staff to follow to check medicines were administered safely. Although, we identified some improvements were needed in these areas.
Staff knew how to identify and respond to concerns about potential abuse. Although, the management of the service did not have a full understanding of their role in this situation.
There were enough staff in place to meet people’s needs. Staff felt supported throughout their time at the service. Staff received regular training in key areas, supervisions and checks on their competency to do their jobs well.
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; the policies and systems in the service supported this practice.
There were plans in place to ensure people were supported to have what they wanted to eat and drink. Relatives told us staff informed them when certain food supplies were getting low. People felt confident staff would respond appropriately if they were unwell.
People and their relatives spoke positively about how the staff were very caring and thoughtful. We saw people were involved in the planning of their care, so it fitted into their lives. Staff were respectful to people and their homes.
The management of Shehkina Care had ensured people were supported by regular staff who knew them and at times people had chosen. Staff were not under pressure to rush people or closely monitor their time. Staff spent time with people and were directed by them. People had regular reviews of their care by the registered manager to check they were happy with the support from the service.
The management was not considering end of life planning or starting this conversation with people, to ensure they knew of their needs and wishes to prepare for this time in people’s lives. We made a recommendation to improve end of life planning.
People, their relatives and staff spoke well of the registered manager and of how the service was managed. The registered manager and the nominated individual had created a positive culture at the service, which put people first.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 25 October 2018 and this is the first inspection.
Why we inspected
This was a planned inspection. We inspect new services within 12 months of their registration with the CQC.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.