Ladies In Waiting

Updated 16 May 2018

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 between 19 and 29 March 2018 and was announced. We gave the provider a short amount of notice that we would be visited the office, because it is small and the registered manager is often out of the office supporting staff or meeting people who use the service. We needed to be sure that they would be in. On 19 and 20 March 2018 we made phone calls to people and their relatives to ask them about the quality of care they received. On 21 March 2018 we visited the provider’s offices to look at care related documentation, speak with the registered manager of the service and also relatives and staff who visited the office. Between 22 and 29 March 2018 we telephoned care workers.

The inspection was carried out by one inspector 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; in this case, the care of older people.

Prior to the inspection we spoke with both the local authority commissioning and safeguarding teams. We reviewed information held on the provider; for example, notifications sent to us by the provider. We reviewed information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with eight people who used the service and four relatives. We spoke with eight care workers and the registered manager. We looked at three people’s care records and records relating to the management of the service including staff training records, audits and meeting minutes. We also gained feedback from two health professionals who worked with the service.

Updated 16 May 2018

The inspection took place between 19 and 29 March 2018 and was announced.

At the last inspection in January 2016 we rated the service ‘Good’ overall and in each domain. At this inspection we found the service had maintained its overall rating of ‘Good’ and improved its rating in the ‘Is the service Caring?’ domain to ‘Outstanding’.

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 the inspection the service was delivering personal care to 25 people.

A registered manager was in place. 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.

We found an extremely caring service. Staff demonstrated very caring values and were highly passionate about the people they were supporting. They had developed exceptionally strong relationships with the people they supported. The trust developed between people and staff helped promote people’s independence, confidence and helped them achieve good outcomes. People had a say in who supported them, and great care was taken to match people and staff with shared interests. We saw staff regularly went the extra mile for people, to ensure their comfort and meet their preferences.

People felt safe using the service. Risks to people’s health were assessed and clear plans of care put in place for staff to follow. People received their medicines safely as prescribed. There were enough staff to ensure a consistent and reliable service.

Effective care was provided. People praised staff skill and knowledge and said staff knew their needs well. The service was very selective about the staff it employed, to ensure they were suitable to work with the client group. Staff demonstrated maturity and a broad knowledge of the people they were supporting. The service worked with a range of health professionals to help meet healthcare needs.

The service was responsive to people’s changing needs. Comprehensive care plans were in place which were subject to regular review involving people and/or their relatives. Everyone said care was appropriate and met people’s individual needs. The service was very effective at meeting people’s social needs and encouraging them to participate in the local community. Comments and complaints made by people were quickly responded to, to help improvement of people’s care experiences.

The service was well managed. People, relatives and staff all praised the approach of the registered manager and said they were effective in their role. There was a clear and visible person centred culture. A range of audits and checks were undertaken by the registered manager to ensure it continued to perform to a high standard. People’s feedback was regularly sought to determine whether any improvements were needed to the service.