The inspection took place on 18 October 2016. The inspection was announced. This was because the service was a domiciliary care service and we needed to be sure that someone would be available so we could carry out our inspection.
Care Needs is a Domiciliary Care service that provides personal care and support to older people who live in their own home. The service covers the Stockport area of Manchester and at the time of our inspection provided support to 90 people.
The service had registered manager in place. The 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.
We spoke with support staff who told us that the registered manager was always available and approachable. Throughout the day we saw staff were comfortable and relaxed with the registered manager and each other. The atmosphere was relaxed and we saw that staff interacted with each other positively.
From looking at peoples care plans we saw that they were written in plain English and in a person centred. Person centred means they put the person first, not the service and made good use of personal history and described individuals’ care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the registered manager.
Individual care plans contained personalised risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The daily records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and care managers.
We spoke with people who used the service and their relatives via telephone calls during the inspection this showed us that people who used the service were supported in a person centred way by sufficient numbers of staff to meet their individual needs and wishes within their own homes and within the community. The recruitment process that we looked into was safe.
When we looked at the staff training records and spoke with the registered manager we could see staff were supported to maintain and develop their skills through training and development opportunities. The staff we spoke with confirmed they attended a range of learning opportunities. They told us they had regular supervisions with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs.
We were unable to observe how the service administered medicines on the day of our inspection. We looked at how records were kept and spoke with the people who used the service, staff and the registered manager about how staff were trained to administer medicines and we found that the medicines administering process was safe.
During the inspection it was evident from the feedback we reviewed that staff had a good rapport with the people who used the service. We received positive feedback from people and their relatives about the support staff.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Any DoLS applications must be made to the Court of Protection.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked to see if the service had procedures in place and was working within the principles of the MCA. At the time of our inspection no applications had been made to the Court of Protection. From speaking to staff and looking at the training records we could see that training for staff was provided regarding MCA and DOLS.
We saw a complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed it.
We found that the service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views via an annual quality survey to collect feedback about the service.
We saw that staff had been actively involved in developing a ‘do’s and don’ts’ staff handbook.