Background to this inspection
Updated
3 May 2018
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 13 March 2018 and was announced. We told the provider two days before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. An inspector and an inspection manager undertook the inspection, with an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience helped us with the telephone calls to get feedback from people who used the service and their relatives.
The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law and any concerns we have received. We contacted the local authority commissioning team, who have responsibility for monitoring the quality and safety of the service provided to local authority funded people. We also contacted four health and social care professionals, and received one response. We spoke with nine people and one relative who used the service.
During the inspection we went to the services office and spoke with the registered manager, a visiting officer, a care coordinator, a senior care worker, and three care staff. We spent time reviewing the records of the service, including policies and procedures, five people’s care and support plans, the personnel records for five care staff, complaints and compliments recording, accident/incident and safeguarding recording, and staff rotas. We also looked at the provider’s quality assurance audits.
This was the first inspection since a change in location for the service.
Updated
3 May 2018
This inspection took place on 13 March 2018 and was announced. This was the first inspection since the service was re-registered following a change in location.
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 younger disabled adults in the Brighton and Hove area. Care was provided predominantly to older people, including people with a physical disability, learning disability, sensory loss, mental health problems or people living with dementia. At the time of our inspection around 81 people were receiving a service of which 58 were receiving the regulated activity of personal care.
The service had a registered manager, who was present for the inspection. 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.
Staff told us there had been a significant period of change in the management arrangements and personnel working in the office and of care staff. The registered manager is also the registered manager for another of the provider’s services and split their time between both these services offices. However, both services were now located in the same building. Feedback from all staff was this had worked well, they were clear of the management arrangements, the registered manager was accessible and contactable if needed. Systems had been put in place to monitor and review the quality of the care provided.
Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005 (MCA), and had taken appropriate action to arrange meetings to make a decision within their best interests. People and a relative told us consent was always sought before any care or support was provided. One person told us, “Yes, they check with me before doing things.” Another person told us, “We have the same carers for so long that they know how we like things done and they do it that way, but nothing formal.” Staff had a good understanding of equality, diversity and human rights.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including the care of people with dementia. Staff had received both supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.
People told us they felt safe with the care and support provided. One person told us, “Yes, perfectly safe,” Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Risks associated with the environment and equipment had been identified and managed.
People told us their care was provided by kind and caring staff. People’s comments included, “They are generally lovely, very kind,” and “Absolutely, very kind and affable.” They said they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector.
Where required, care staff supported people to eat and drink and maintain a healthy diet. People were supported with their healthcare needs. Medicines were managed safely and people received the support they required from staff.
People were encouraged to express their views and had completed surveys. They also said they felt listened to and any concerns or issues they raised were addressed. Technology was used to assist people’s care provision.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where senior staff were always available to address any problems or concerns.