A single inspector carried out this inspection and the registered manager was present throughout our visits to the office. The registered manager informed us that Care Dynamics Ltd had during the past year started to provide care for older people in their homes. They had previously supported only people with learning disabilities. There were 25 people receiving a service at the time we inspected, 10 with learning disabilities and 15 older people.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.
We considered our inspection findings to answer questions we always ask:
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
This is a summary of what we found.
Is the service safe?
Care plans addressed risks to people's health, safety and welfare. We saw that care records contained person-specific risk assessments and management plans. These addressed any risks identified for the person, such as the risk of falling, or risks associated with heath conditions such as diabetes.
People were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. Staff lacked clear instructions about how to assist or prompt people to apply their creams. Staff assisted a person with their skin cream but did not record this in the person's medicines administration records. The staff we spoke with told us that they generally recorded any assistance or prompting they gave people regarding their skin creams in care logs rather than in medicines administration records.
People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The people we spoke with all indicated they felt safe with staff and said that staff treated their property with care. Support workers were aware of signs or issues that could indicate a concern.
Appropriate checks were undertaken before staff began work, to help ensure that staff were safe to work with people.
Is the service effective?
People were positive about the care and support they received. Both people with learning disabilities said they had a programme of activities that they had chosen themselves and that their support workers helped them to follow this. One person said that their regular staff were 'superb' and 'know what sort of things I need and I like'.
Is the service caring?
People told us they liked their support workers. For example, one person said their support workers were 'really good' and another person described them as 'nice and kind'. We visited three people in their own homes and observed that they had a good rapport with their staff, who treated them respectfully.
Is the service responsive?
Care plans reflected people's assessed needs and contained instructions for care workers so that people received the help and support they needed. The care records we looked at showed that people's needs had been assessed before they received a service. People told us that they had been consulted about their care plans. One person told us, '[The manager] came and went through it all and made sure that I was happy with it.'
People told us they had a regular team of support workers, received a rota in advance so they knew who to expect, and said that staff generally arrived promptly.
There was an effective complaints system available. Comments and complaints people made were responded to appropriately. All six people we spoke with told us they felt able to raise any concerns about their or their relative's service with the management.
Is the service well-led?
The provider had an effective system to regularly assess and monitor the quality of service that people receive, and to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The registered manager sent out quarterly quality assurance surveys to people who use the service, and senior staff also telephoned or visited people to check their satisfaction with the service. A relative told us, 'Every so often you'll get a phone call asking if there are any concerns or problems.' There was a system of spot checks in place to ensure that staff followed Care Dynamics Ltd policies and procedures.