29 May 2014
During a routine inspection
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People who used the service told us they felt safe because their rights and dignity were respected and they were involved in making decisions about any risks they may decide to take in their daily lives. One person said, 'It's good to feel safe and secure.'
We spoke with staff and they told us they knew what to do if concerns about abuse were raised and they were aware of the provider's policies and procedures to safeguard people from potential abuse.
The staff and the provider understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and Deprivation of Liberty Safeguards (as they related to domiciliary care) and put them into practice to protect people. This meant that people who used the service were protected from harassment, avoidable harm, abuse and breaches of their human rights.
Recruitment practice was safe and thorough. Checks required by legislation had been done before the applicant was employed. This meant suitable staff were employed to care for vulnerable people.
Is the service effective?
People told us that they could express their views about their health and quality of life. They said these were taken into account in the assessment of their needs and the planning of the service. People told us they had been involved in the assessment of their needs prior to accepting care from the agency. The care records we looked at reflected people's current individual needs, choices and preferences.
We reviewed records that showed staff received effective recruitment, support, supervision and training. The provider had an ongoing workforce development plan that encouraged staff to develop and promote good practice. This meant that people received effective care from staff who had the knowledge and skills necessary to carry out their roles and responsibilities.
Is the service caring?
People told us that they were treated with kindness and compassion and that their dignity was respected when receiving personal care. People explained how their individual needs were met, including needs around age and disability. Staff we spoke with knew the people they were caring for well, including their preferences and personal histories. This meant that caring, positive relationships were developed with people living in their own home.
Records were stored in the office so that people were assured that information about them was treated in confidence. Staff we spoke with described how they promoted respectful behaviour and positive attitudes. We were shown records that showed staff had been trained in policies and procedures and how to respect people's privacy, dignity and human rights in their home. This meant people's privacy and dignity was respected and promoted.
People and those that mattered to them were encouraged to make their views known about their care and support, and these were respected. This meant people were listened to and felt that they mattered.
Is the service responsive?
People said that they and their family were encouraged to make their views known about their care and support. One person explained how staff made sure that they had the time they needed to make decisions about their life. Care records detailed how people's individual needs were regularly assessed and met. The way staff talked about people showed that they actively sought and listened to people's views and decisions. This meant people were supported to express their views and be actively involved in making decisions about their care and support.
The provider considered the activity preferences of people so that they could assist them to lead a meaningful life in their home environment. This meant people could still access activities that were important and relevant to them and they were protected from social isolation. People were very much enabled to maintain relationships with their friends and relatives. Staff we spoke with recognised the risks of social isolation and loneliness with people. Staff worked hard to balance the risk against this and how they wanted to live their life. This meant that people received personalised care that was responsive to their needs
Is the service well-led?
Discussion with the provider and staff showed there was an emphasis on fairness, support, transparency and an open culture in the service. Staff were supported to question practice through robust supervision arrangements. The provider operated a clear set of values that included involvement, compassion, dignity, respect and independence. This was understood by all staff we spoke with. This meant that the service promoted a positive culture that was person centred, open, inclusive and empowering.
Quality assurance was in place and used to drive improvement. There were effective arrangements to continually review health and safety in people's homes, safeguarding concerns, infection control and food hygiene.
The provider had links with organisations that acted as sources of best practice. For example, for quality assurance processes and training. This meant that the provider demonstrated good management and leadership.
Staff we spoke with knew and understood what was expected of them. Effective supervision processes were in place for staff to account for their decisions, actions, behaviours and performance. This ensured that responsibility and accountability was understood at all levels. A person said, 'Managerially the agency has dignified care as its standard ' excellent.'