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Chiltern Homecare Ltd Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 February 2019

This inspection started on 29 November 2018 and was completed on 3 December 2018 and was announced. We gave the provider 48 hours’ notice of our intended inspection to make sure someone would be available to assist us with locating documents. The inspection began on 29 November and was completed on 3 December. We asked the provider to request authority from people to visit them in their homes. People agreed to our request and was happy for us to visit them in their homes.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and disabled adults. At the time of our inspection the service was supporting six people.

The service is required to have a registered manager to manage the service. At the time of our inspection a registered manager was managing the service. 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 we spoke with told us the service was good and they thought the staff were good and knew how to take care of them. People we visited said, “Very good, they are marvellous they know what’s what” and “Oh yes, they know what to do alright.”

Staff received training in safeguarding and were aware of their responsibilities of reporting any concerns to the relevant authority. There were sufficient numbers of staff to support people. The service had robust recruitment procedures in place. The provider did not use any agency staff to support people.

Staff received regular supervisions and appraisals. Staff told us the registered manager was always at the end of the phone if they required advice or support. The provider told us they spoke with staff on a daily basis.

Medicines were not managed safely at the time of our inspection. The provider had not followed best practice guidelines in the administration of medicines.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A complaints procedure was given to people when they first joined the service. There had been no complaints since the service was first registered.

Staff were appropriately inducted and completed mandatory training before they supported people. However, some tasks were carried out without the relevant training. The registered manager told us they carried out spot checks to monitor staff.

The service supported people with their meals. People were monitored who were at risk of malnutrition. However, the provider had not used an assessment tool such as the Malnutrition Screening Tool (MUST).

We have made a recommendation in relation to this.

Risk assessments were mostly in place for people when they first joined the service. However, specific risks for people with additional support needs were not assessed or in place at the time of our inspection.

Staff had access to personal protective equipment to protect people and understood their roles and responsibilities in relation to infection control and hygiene.

The provider had had systems and processes to record and learn from accidents and incidents that identified trends and helped prevent re-occurrence.

People were able to access health care professionals to maintain their health and well-being. We saw community nurses and occupational therapists were involved in the support of people who used the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 15 February 2019

The service was not always safe.

Medicines were not managed according to legislation and guidelines for safe practice.

Risks to people were not always identified and monitored.

Robust recruitment procedures were used to ensure only the correct staff were recruited.

Effective

Good

Updated 15 February 2019

The service was effective.

Staff were appropriately inducted when they first joined the service.

People were able to make decisions about their care and day to day lives.

People received support to attend healthcare appointments and keep healthy.

Caring

Good

Updated 15 February 2019

The service was caring.

People were supported to be independent and access the community.

Staff treated people with respect and protected their dignity.

Responsive

Requires improvement

Updated 15 February 2019

The service was not always responsive.

Care plans did not always contain information and details of how staff should support people with specific needs.

There were procedures for making complaints about the service.

People were able to access the community to avoid social isolation.

Well-led

Requires improvement

Updated 15 February 2019

The service was not always well led.

Robust auditing systems were not in place to make sure people�s needs were met.

The registered manager kept under review the culture of the service.