26 November 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by two inspectors and an assistant inspector.
Service and service type
The service is registered as a domiciliary care agency and provides care and support to people living in their own homes.
Not everyone receiving a service received support with personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where this support is provided, we also consider any wider social care provided. At the time of the inspection 17 people were receiving personal care from the service.
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 a short period notice of the inspection because some of the people using it could not consent to a home visit from the inspector. This meant that we had to arrange for ‘best interests’ discussions about this. We also needed to ensure the provider or registered manager would be available to support a visit to the services office.
Inspection activity started on 12 October 2021 and ended on 02 November 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who commission services from the provider. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about the service, what they so well, and improvements they plan to make. This information helps to support our inspection. We used all this information to plan our inspection.
During the inspection-
We met and spoke with three people who used the service. When we met with people, we were also able to meet and observe the care staff supporting them. This helped us to better understand people’s experiences and the quality of care provided. We spoke with 14 members of staff, which included, the registered manager and care staff, and we also received feedback from a further seven staff by email. We visited the office and met with the registered manager, development manager and one of the company directors.
We looked at the care and medicines records of six people who used the service. Care records included, care plans, risk assessments, daily monitoring records and incident reports. We looked at the recruitment records of three members of staff. A variety of records relating to the management of the service were reviewed. This included quality audits, health and safety records and policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with five professionals who regularly visit the service.
26 November 2021
I-grow Care and Support (known locally as i-grow) provides care and support to younger and older adults living in their own homes who may have a learning disability and/or autism, physical disabilities, acquired brain injuries or mental health issues. Not everyone who used the service received personal care. The Care Quality Commission only inspects where people receive personal care. This is help with tasks related to personal hygiene, medicines and diet. Where this support is provided, we also consider any wider social care provided.
At the time of the inspection 17 people were receiving support with personal care and lived within Plymouth and surrounding areas. Some of these people received care and support on a 24-hour, seven day a week basis. Others received support at particular times of the day when needed.
People’s experience of using this service and what we found
We received mixed feedback from staff regarding the quality of training, communication and support. The registered manager told us they were aware of some of the issues raised by staff and said some areas of training and support had been affected by the COVID-19 pandemic. A staff survey had been completed and an action plan was in place to address issues raised. This included reintroducing weekly calls to staff and face-to-face visits to provide support. It was too early for us to see the impact of these improvements.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right care, Right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, Right care, Right culture. People received a service that was personalised and took their specific choices into account. The management team and staff worked with people and their families from the point of referral to develop a plan of care that met their needs and desired outcomes. Some people had been supported to move into their own home where they had been able to make choices for the first time about their care and lifestyle. People had been supported to access work opportunities, develop new friendships and plan holidays of their choice.
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.
Other agencies told us they felt the service was well-led and provided personalised care that provided good outcomes for people.
The positive and friendly interactions we observed between people and staff indicated people felt safe and comfortable in their home Robust recruitment practices ensured the right staff were available to support people safely.
People were supported by staff to keep healthy and well. People’s care plans set out how staff should support them to manage their health and staff supported people to access health services when required. People were supported to take their medicines safely, in a way that suited them.
Regular audits were carried out with action plans and timescales for improvement.
We have made recommendations in relation to training, support and complaints.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was Good (Published 23 February 2018)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.