Home First - Stoke

Home First -Stoke is registered as a domiciliary care service and commissioned to provide 1800 hours of support each week. At the time of inspection, they were supporting with 110 people, 52 of whom were receiving the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Support was provided to people in their own homes on a short-term basis, usually between 2-6 weeks. The main office was based in a large building surrounded by other NHS and social care services.

People’s experience of using this service and what we found

People were supported by sufficient numbers of staff however the provider was not always able to provide a consistent staff team to undertake the care calls. Since the last inspection people were given more information about the service and how care calls would not always be set, but people still told us they would prefer greater predictability.

Due to the nature of the service, support was often restricted to the care tasks which had been agreed in advance.

People were treated with dignity and respect. An update to people's care assessment was needed, to ensure all of the protected characteristics were considered. People felt able to express their views.

People were protected from abuse by staff who had been trained in recognising and reporting abuse and issues of delayed reporting to the local authority had been resolved.

Risks to people’s safety were assessed and systems were in place to ensure key risks were clearly highlighted. People received their medicine from staff who had been trained in the safe administration of medicine. People were protected from the risk of infection by staff who had access to gloves which they wore during personal care.

There was a strong focus in the service on learning lessons when things went wrong and continuously trying to improve.

People’s needs were holistically assessed, and staff received training in how to support people with a range of different needs. The provider worked closely with other agencies to help people meet their desired outcomes.

People were supported to have their health needs met and people were supported with drinks and meals as required.

People were supported to have choice and control of their lives, as far at the service could facilitate. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Care was personalised to people’s assessed needs and information was made accessible when required. People’s care calls were managed to ensure they were able to maintain social activities.

Any complaints received were fully investigated and action taken when needed. People were supported with end of life care.

People told us the service was well managed, and staff told us they felt supported and kept up to date with what was happening in the service. The provider engaged with people and worked in partnership with others. The provider understood its duty of candour.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 12 December 2018.)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At this inspection Home First - Stoke were providing personal care for 111 people.

At the time of this inspection Home First – Stoke did not have a registered manager in post. Day to day management of the service was provided by an interim service manager. We were informed by the interim service manager that a decision had yet to be made regarding the registered manager position. 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.

The inspection activity started on 30 October 2018 and ended on 6 November 2018. This service has not been previously inspected.

People did not receive support at a time that suited their personal circumstances or individual preferences.

The provider was not meeting its requirements of registration with the Care Quality Commission as it did not have a registered manager in post at the time of this inspection.

People were safe as staff members had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care and support. Staff members knew how to support people in a way that minimised the risks of harm associated with their care. The provider followed infection prevention and control guidance. The provider ensured that the equipment people used was in safe working order. When needed, people received help with their medicines from staff who were trained to safely support them. The provider undertook regular checks to ensure people received their medicines as directed.

The provider completed checks on staff before they started work to ensure they were safe to work with people. The provider had systems in place to address any unsafe staff practice which included disciplinary action or retraining if needed.

People received care from staff that had the skills and knowledge to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to those they supported and any additional training needed to meet people’s requirements was provided.

People had their rights protected by staff members who were aware of current guidance informing their practice. Staff received support and guidance from a management team who they found approachable.

People had positive relationships with the staff members who supported them. People’s care and support needs and preferences were known by staff who assisted them in a way which was personal to them. People were involved in decisions about their care and had information they needed in a way they understood.

People had their privacy and dignity respected and information personal to them was treated confidentially. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health. People were given information in a way they could understand.

The provider completed regular quality checks to satisfy themselves that people were receiving appropriate support and care. People felt confident they were listened to and their views were valued. People and staff felt able to express their views and felt their opinions mattered. The provider had good links with community based facilities and worked in conjunction with other health care professionals to promote positive outcomes for people.