29 June 2018
During a routine inspection
At our last inspection of the service in November 2017 we found the service to be meeting the requirements of the regulations. We were unable to provide a rating at our last inspection, or the inspection prior to this carried out in September 2016. This was because we determined that the service was not fully operational due to supporting few people and intending to expand in size.
At this inspection the service was still providing a limited service. However, as this had been the case since our inspection in September 2016 we considered the service to be fully operational. We considered that we had sufficient evidence to make a ratings judgement for whether the service was effective, caring, responsive and well-led and to provide an overall rating. However, we judged we did not have sufficient evidence to provide a rating for the safe key question.
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. At the time of our inspection, the service was providing home care support to four people. However, only one person using African Caribbean Care Group received a regulated activity. This person received three hours of support per week.
CQC only inspects the service being received by people provided with ‘personal care’ in a place that they are living. Personal care includes help with tasks related to personal hygiene and eating. Where people receive this support, we also take into account any wider social care provided. The provider also ran other services including a day service for older adults, a meals service and a transport service. CQC do not regulate these services, and this inspection only considered evidence relevant to the provision of the domiciliary care service. We have also referred to this as the ‘regulated service’ within the inspection report.
There was a registered manager in post. 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.
One staff member provided support to the people receiving a home care service. When they were absent, as was the case at the time of our inspection, the service manager told us day service staff could provide cover, or arrangements would be made with people’s families to cover the absence themselves. The relative we spoke with was happy with this arrangement. They told us staff attended calls on time and always stayed for the agreed duration of the call or longer.
The provider ran an advocacy service that was accessible to people using the home care service as well as people from the wider community. This service was able to provide advice and guidance in relation to a range of areas. The relative we spoke with told us staff were good at providing them with information and advice whenever they needed it.
The service supported people primarily, but not exclusively from the African Caribbean community. Staff were clear about the service’s values and purpose, which were to provide culturally appropriate support and help prevent social isolation.
Staff assessed risks to people’s health and wellbeing, and plans were in place to help minimise the likelihood of people being harmed. There was scope to increase the level of detail recorded in risk assessments.
The provider had systems in place to help ensure any accidents, incidents or safeguarding concerns were identified and reported. However, there had not been any such incidents since our last inspection so we were not able to determine how effective this system was.
The staff member working for the home care service had received a range of training relevant to
their job role. This staff member had not received a formal supervision or competency check since
they started work. The service manager told us they found feedback from the relatives of people
using the service was ‘the biggest tell’ as to the competence of staff and quality of the service they
provided. Given the small scale of the service, this approach was adequate.
The care plan we reviewed evidenced that staff had assessed people’s holistic health and social
care needs. People’s preferences were also reflected in their care plans, although there was little
information on social history or specific routines that staff followed during calls. However, as care
was provided by just one staff member, this would reduce the likelihood of this having any impact,
and would ensure people received consistent support from staff they knew well.
The service had strong links with the local community who were involved in the running of the
service. We saw there were frequent community meetings, and staff told us the centre where the
service was based acted as a ‘community hub’. The provider arranged a variety of activities that
would help support the health and wellbeing of people in the community. This included a dementia
café, cancer awareness event and holistic therapy sessions.
There were few formal systems being operated to help the provider monitor the quality and safety
of the service. The registered manager and service manager instead relied primarily on
feedback received informally through contact with people using the service, family members and
the community. We considered this approach to be adequate at this time given the small scale of
the service.
The service was not providing support with medicines to anyone using the regulated service at the time of our inspection.
The service had a complaints policy that would help guide people how to make a complaint. The service manager told us no complaints had been received since our last inspection. The relative we spoke with told us they felt staff listened to them and their family member.