Background to this inspection
Updated
22 September 2016
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 of First Call Community Systems Limited took place on 19 July 2016 and was announced. We gave 24 hours’ notice of the inspection because the location provided a domiciliary care service, was small and we needed to be sure that someone would be available to assist us with the inspection. One Adult Social Care inspector carried out the inspection.
Information had been gathered before the inspection from notifications that had been sent to the Care Quality Commission (CQC). Notifications are when registered providers send us information about certain changes, events or incidents that occur. We also requested feedback from local authorities that contracted services with First Call Community Systems Limited and reviewed information from people who had contacted CQC to make their views known about the service. We did not receive a ‘provider information return’ (PIR) from the registered provider, but this had not been requested by the Commission. A PIR 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.
We spoke with seven people that used the service, one relative, the registered manager, area manager and three support workers that worked at First Call Community Systems Limited. We looked at care files for three people that used the service and at the recruitment files and training records for three support workers. Records and documentation relating to the running of the service, including the quality assurance and monitoring, medication management and premises safety systems that were implemented, were also reviewed. We also looked at equipment maintenance records and records held in respect of complaints and compliments.
Updated
22 September 2016
The inspection of First Call Community Systems Limited took place on 19 July 2016 and was announced. At the last inspection on 12 September 2014 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
First Call Community Systems Limited is a domiciliary care agency (DCA) providing care and support to adults and younger adults who may be living with dementia, a learning disability or autistic spectrum disorder, mental health issues, a physical disability or sensory impairment. At the time of our inspection there were 31 people using the service. The service provides personal care, for example, assistance with washing and dressing and also provides domestic help, including shopping and assisting with housework, to people living in their own homes in York.
This service applied to change the location address of its York office in autumn 2014, but has been in operation for several years. This is the first comprehensive rated inspection at the location.
The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for the last four months. The registered manager was supported by an area manager during the inspection, because of this.
A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Workers were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were managed and reduced so that people avoided injury of harm.
The office premises were safely maintained and there was evidence to show that maintenance contracts were in place. Staffing numbers were sufficient to meet people’s need and we saw that rosters reflected the times and frequency of calls that people required, as recorded in their support packages. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people. We found that the support provided to people that used the service with their medication was safely carried out.
We saw that people were supported by qualified and competent workers that were regularly supervised and who received appraisals regarding their personal performance. People’s mental capacity was appropriately assessed and their rights were protected within the framework of appropriate legislation if necessary. Employees of the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. When people were assessed as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interests. The registered manager made appropriate referrals to the Court of Protection in these cases. However, this had not been necessary for some time.
People received support with adequate nutrition and hydration to maintain their health and wellbeing, if this was a requirement of their support package. We found that people received compassionate care from kind workers, that knew about people’s needs and preferences. We found that people were always asked for their consent before workers undertook care and support tasks.
People’s wellbeing, privacy, dignity and independence were monitored and respected and workers aimed to maintain these wherever possible. This ensured people were respected, that they felt satisfied and were encouraged to keep control over their lives.
We saw that people were supported according to their person-centred support plans, which reflected their needs well and which were regularly reviewed. People were encouraged to maintain good family connections and support networks. There was an effective complaint procedure in place and people were able to have complaints investigated without bias.
The service was well-led and people had the benefit of this because the culture and the management style of the service were positive and progressive. There was an effective system in place for checking the quality of the service using audits, satisfaction surveys and meetings.
People that used the service had opportunities to make their views known through direct discussion with the registered provider or workers and through more formal complaint and quality monitoring formats. They were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in their homes or in the agency office.