Background to this inspection
Updated
23 October 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
This inspection was carried out by one inspector and an Expert by Experience made phone calls to people and relatives who used this service. 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and 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. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 23 September 2019 and ended on 3 October 2019. We visited the office location on 23 September 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff, the registered manager, managing director and the HR officer.
We reviewed a range of records. This included five people’s care records and medicines records. We looked at four files in relation to recruitment. A variety of records relating to the management of the service including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at information about recruitment, incidents and medicines. We contacted one professional and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Updated
23 October 2019
About the service
There4u (Salisbury) Ltd. is a domiciliary care agency providing care and support for people living in and around Salisbury. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were protected from the risk of abuse by staff who had been trained in safeguarding and knew what action to take if they were concerned. People’s risks had been identified and plans in place to minimise the risks. Staff were available to carry out the packages of care agreed and had been recruited safely. Incidents had been recorded and discussed at management meetings. Staff supported people to take their medicines and had been trained in medicines management. There was not always enough detail to guide staff to know when to administer ‘as required’ PRN medicines.
We have made a recommendation about ‘as required’ PRN protocols in the safe section of the report.
People received effective care from staff who were trained and were supported in their roles. Staff helped people to access healthcare professionals where needed and worked as a team to meet people’s needs. 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.
People were cared for by staff who treated them with respect and with dignity. Comments about the staff included, “Staff are kind, all so lovely”, “Staff are very caring, nothing is too much trouble” and “Staff are very reliable and not missed a visit.” Privacy was maintained with records being stored securely.
People had their own care plan which recorded their personalised support. Staff kept daily notes which were all held on an electronic system. Staff used an ‘app’ to access the system with a password. Information on how to complain about the service was shared with people in a ‘welcome pack’ which they received when they started with the service. End of life care could be provided and the service worked with healthcare professionals to deliver this.
The service had a registered manager who was also the provider. They were experienced, visible and approachable. Staff told us they would not hesitate to contact the registered manager if they needed to. Team meetings were held weekly where staff could attend and raise any concerns. Quality monitoring was in place with checks being carried out. This included observations of staff in people’s homes and asking people for feedback about their care received. There was no service development plan for this service where all actions that were required were recorded.
We have made a recommendation about quality monitoring in the well-led section of the report.
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 30 September 2016). Since this rating was awarded the service has moved premises and changed name. For people using this service nothing else had changed. This service used to be called Cross Keys House. The changes happened on the 22 July 2019. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected - This was a planned inspection based on the previous rating.
Follow up
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.