Background to this inspection
Updated
15 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place between 29 November 2018 and 3 December 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection site visit activity started on 29 November 2018 and ended on 3 December 2018. It included visits to people’s homes. We visited the office location on 29 November 2018 to see the manager and office staff and to review care records and policies and procedures.
The inspection was carried out by one inspector. Prior to the inspection we reviewed notifications we had received since our last inspection. Notifications are information about important events which the service is required to send us by law. We requested the provider to send us a Provider Information Return (PIR). A PIR is information we require providers to send us at least once annually to give some key information about the service, what it does well and improvements they plan to make. Due to technical problems, the provider was not able to complete a PIR.
We looked at three people’s care plans, three medicine charts, four recruitment files, training records and accident records. In addition, we viewed supervision records, visited two people in their home and spoke with three members of staff and two relatives.
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.