Background to this inspection
Updated
10 December 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 on 24 November 2016 and was announced. We gave the provider 48 hours’ notice of the inspection because they and the registered manager are sometimes out of the office supporting staff or people who use the service. We needed to be sure that they would be available to speak with us on the day of our inspection. The inspection was undertaken by a single inspector.
Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information such as statutory notifications about events or incidents that have occurred, involving people using the service and which the provider is required to submit to CQC.
During the inspection we spoke to the provider and the registered manager. We reviewed the care records of five people using service, three staff files and other records relating to the management of the service.
After the inspection we undertook telephone calls and spoke to six people using the service. We also spoke to relatives of three other people using the service. We asked people and relatives for their views and experiences of the service.
Updated
10 December 2016
This inspection took place on 24 November 2016 and was announced. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in October 2015. We gave the service an overall rating of 'requires improvement' because we found the provider was in breach of the regulations. This was because they had not sent CQC statutory notifications about events or incidents that had occurred, involving people using the service, which they were legally required to do. We did not identify any further breaches but we found some aspects of the service were inconsistent. There were gaps in employment checks undertaken by the provider, some aspects of medicines management did not reflect best practice and the quality of records maintained by the service was inconsistent. We asked the provider to take action to make improvements in respect of the breach in regulation. We went back to the service in March 2016 to check that improvement had been made and found this regulation was being met.
Chenash Homecare Specialists is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were 35 people receiving personal care from this service, the majority of whom were funded by their local authority. People using the service were mostly older adults who had a wide range of healthcare needs and conditions. The package of care and support provided to each person varied between a few hours a week to several times a day, depending on their specific needs.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.
At this inspection we found the provider had continued to maintain the improvements made in respect of prompt submission of statutory notifications. Records of events and incidents maintained by the service matched the information we held on our records.
We found improvements had been made to the management and maintenance of records. Staff now had access to all the information they needed to support people, in one central record. Records the provider maintained about staff contained appropriate information. These now contained evidence of the support staff received through supervision (one to one meetings).
The provider had improved their recruitment practices. Appropriate employment and criminal records checks had been carried out all new staff to ensure they were suitable and fit to work for the service.
We also found improvements had been made to the way staff recorded information about medicines. The provider had updated their medicines policy after our last inspection. They had provided training and support to all staff to ensure the service maintained a clear, accountable record for when and by whom medicines had been administered.
People felt safe with the support provided by the service. Staff were supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse or being harmed by discriminatory behaviour or practices. Risk of injury or harm posed to people by their specific healthcare needs and home environment had been assessed. Plans were put in place which instructed staff on how to minimise identified risks to keep people safe.
The registered manager planned and managed all scheduled visits to people, taking account of their specific care and support needs. This enabled them to ensure appropriately skilled staff were assigned to meet these safely. The majority of people said staff attended scheduled visits on time. This indicated there were sufficient numbers of staff to meet people’s needs. Staffing levels and the timeliness of scheduled visits was continuously monitored by the registered manager. The registered manager, wherever possible, scheduled visits so that people received support from the same members of staff, in order to experience consistency and continuity in their care.
People were involved in discussions about their care and support needs. People’s support plans set out how their needs should be met by staff and reflected their individual choices and preferences. Plans were regularly reviewed to identify any changes that may be needed to the support people received. People said staff were able to meet their needs. They told us staff were kind, caring and respectful. People’s right to privacy and to be treated with dignity was maintained by staff, particularly when receiving personal care. People were encouraged to do as much as they could and wanted to do for themselves to retain control and independence.
Staff received training to meet people’s needs. Training was in areas and topics relevant to their work. The provider and registered manager monitored training to ensure staff skills and knowledge were kept up to date. Staff received regular supervision so that they were appropriately supported to care for people.
People were supported by staff to maintain their health and wellbeing. Staff helped people to take their prescribed medicines when they needed these. They monitored people’s general health and wellbeing and where they had any issues or concerns about this they took appropriate action so that attention could be sought promptly from the relevant healthcare professionals. Where the service was responsible for this, people were supported to eat and drink sufficient amounts.
The majority of people were satisfied with the care and support they received. People knew how to make a complaint if needed. The provider sought the views and experiences of people and their relatives about the quality of care and support provided and how this could be improved. Since our last inspection the provider had extended this to include the views of health and social care professionals that worked closely with people. The provider used this information along with other checks to assess and review the quality of service people experienced. Where there were any shortfalls or gaps identified through these checks the provider and registered manager took action to address these.
We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff were fully aware of their responsibilities in relation to the Act.