Background to this inspection
Updated
7 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection took place on the 7 March 2017 and was announced. The provider was given 48 hour’s notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.
The inspection team consisted of two inspectors and 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 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 the service does well and improvements they plan to make.
Before the inspection we checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law. We used all this information to decide which areas to focus on during our inspection.
During our inspection we spoke with 12 people and four relatives on the telephone, three care staff, two senior carers, a business development manager, regional director and the manager. We observed the manager and staff working in the office dealing with issues and speaking with people over the telephone.
We reviewed a range of records about people’s care and how the service was managed. These included the care records for six people, medicine administration record (MAR) sheets, five staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.
We contacted two health care professionals after the inspection to gain their views of the service.
At the last inspection on 13 January 2015 we found the service was not consistently responsive. Assessments had been undertaken and care plans developed to identify people’s health and support needs. However these documents were not always consistent with enough detail to support staff. Staff also felt they did not always have enough travel time in between visits to people in their homes. At this inspection we saw the provider had taken action to improve the service following our last inspection.
Updated
7 April 2017
The inspection took place on the 7 March 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.
Care Your Way is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. These included older people and people living with dementia. At the time of our inspection 69 people were receiving a service.
The service did not have a registered manager. 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 previous registered manager had recently left the service. The provider had recruited a new manager who was currently registering with us.
The majority of people we spoke with were aware that there was a new manager who was in post following the previous one leaving, and felt it was too soon for them to comment on the new manager. However people told us communication and organisation from the office could be improved. One person told us “Administration in the office on the surface don't seem to be organised the phone is not manned 100% of the time”. Another person said “Care staff do well but administration and organisation could be improved”. These issues were brought to the attention of the manager as areas in need of improvement.
People told us they felt safe, that staff were kind and the care they received was good. One person told us “I feel safe because the carers know what they are doing”. There were systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The manager made sure there was enough staff at all times to meet people’s needs.
Staff had the skills and knowledge to meet people’s needs. Staff received regular training to ensure they had up to date information to undertake their roles and responsibilities. Staff also received regular supervision throughout the year.
The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance.
People and relatives told us that staff were kind and caring. Comments included “I think they have my best interests at heart” and “The ladies who call are excellent. All of them will do anything I ask them to do”. A relative told us “I haven’t had one which hasn’t been caring and she (relative) looks forward to them coming in and she will chat to them. I couldn’t do without them, they are my life line as well”.
People and relatives confirmed staff respected their privacy and dignity. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People were supported at mealtimes to access food and drink of their choice. One person told us “They serve a good meal and are obliging”
The provider and manager monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by surveys which were sent to people and their relatives. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues.
Staff told us they were able to speak to the manager when needed, and found them supportive. Comments from care staff included “The new manager and area director are brilliant” and “Wouldn’t change anything, we have a really good team”.