This comprehensive inspection took place on the 25 and 26 January 2018 and was announced.
188 Upper Luton Road is a small domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older and younger adults, including people with dementia and physical disabilities.
Not everyone using the service 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. At the time of the inspection, there were five people receiving the regulated activity of personal care from the service.
At our last inspection, the service was rated Good. At this inspection we found the service remained Good.
There continued to be a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People continued to receive care that was safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.
There continued to be enough suitably qualified staff available to meet people's needs. The service was flexible and responded to people's changing needs. People told us they were able to request their visits at agreed times. People and relatives we spoke with told us they had never experienced a missed care visit.
People continued to receive care from staff that were caring, kind and compassionate. People were treated with dignity and respect and staff ensured their privacy was maintained.
People were encouraged to make decisions about how their care was provided. Staff had a good understanding of people's needs and preferences.
People’s needs continued to be assessed, their care provided in line with up to date guidance and best practice. People’s cultural and religious needs were taken into consideration at the time of assessment.
People received care from staff that had received training and support to carry out their roles.
Risks continued to be assessed and recorded by staff to protect people. There continued to be systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.
Staff continued to support people to attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.
Staff told us that they seek guidance from healthcare professionals as required. They told us they would speak with people’s families and inform the manager if they had any concerns about people’s health.
Staff understood the Mental Capacity Act 2005 and how to support people's best interest if they lacked capacity. People continued to be 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 support this practice.
Staff continued to have good levels of support and supervision to enable them to carry out their roles. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people using the service.
Staff continued to be recruited safely through a robust recruitment and selection process. This enabled the provider to select staff that were suitable to work with vulnerable people. Staff received an induction which included mandatory training and shadowing experienced staff.
The provider had a system in place to ensure people received their medicines as prescribed. Staff continued to receive training to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.
There continued to be policies in place which ensured people would be listened to and treated fairly if they complained. The provider had a robust process in place to enable them to respond to people and their concerns, investigate them and had taken action to address their concerns.
The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement.
Procedures for reporting safeguarding concerns continued to be in place. The provider knew how and when they should escalate concerns following the local authorities safeguarding protocols.
The provider continued to have processes in place to monitor the delivery of the service. People’s views were obtained through surveys, one-to-one meetings, meetings with people’s families and meetings with social workers.
Quality assurance audits continued to be carried out to identify any shortfalls within the service and how the service could improve.
Staff continued to have access to an ‘out of hours’ support that they could contact during evenings and weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.
The provider and staff were committed to the values and vision of the company and they took these into account when delivering care and support.
Further information is in the detailed findings below.