29 November 2018
During a routine inspection
At our last inspection the overall rating of the service was ‘good’. At this inspection we found that evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Safe recruitment practices were in place to protect people from unsuitable staff. Staff were aware of their responsibilities to safeguard people from abuse and there was a whistleblowing policy which staff felt confident to use if they needed to report poor practice.
There were sufficient staff to care for people. Risks to people's safety were assessed and measures put in place to mitigate any risks. Medicines were administered safely. Infection control was covered in the induction and practice was checked through spot checks carried out by senior staff. This was well managed and staff understood their responsibilities.
People's care plans showed an assessment of their needs had been undertaken by the service before any care and support was provided. People that we visited confirmed that they were happy with the support from the provider and that their needs were being met as agreed in the assessment and recorded in the care plan.
There was good support in place for staff. This included an induction that covered key areas of knowledge, shadowing experienced members of staff, competency checks and spot checks by senior staff. We have made a recommendation about staff training on the subject of moving and handling.
People had access to external healthcare professionals and the care files demonstrated that the service was responsive to people’s health needs.
Support with food and drink was identified in the initial assessment and was transferred into the support plan.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People told us that the staff were kind and caring and people were involved in their care and this included regular reviews.
People’s independence was promoted and staff were very clear that it was their role to encourage people to do as much as possible for themselves before providing an intervention. Staff understood how to protect people’s privacy and dignity.
Equality and Diversity information in the care files was revised during the inspection to ensure that people were given the opportunity to share relevant information if they chose to in line with the Equality Act 2010.
Access to independent advocacy was promoted and information about how to contact these services were in the files that we looked at in people’s homes.
The service had improved and was now responsive. Care plans were produced in partnership with the person to meet their identified needs. Each file had a checklist that was signed by people to confirm that everything had been completed as required. The care plans were well organised with a clear consistent format that was easy to follow. There was detailed information about people’s needs and clear guidance for staff to follow.
The care files were person centred and we saw evidence that the service was responsive to changing needs.
There were good systems in place to manage complaints. Accidents and incidents were managed appropriately. The service received good feedback from annual surveys and good feedback collected throughout the year.
The service met the Accessible Information Standard. They routinely asked what people’s communication needs and preferences were, and these were clearly recorded in the people’s files that we looked at.
The service did not deliver end of life care directly but could support relevant professionals such as district nurses where applicable.
The service was well led. The registered manager was committed and staff received good support. The service had good systems in place to monitor performance. Feedback from staff we spoke with about the manager was overwhelmingly positive.
The service had policies and procedures in place, which covered all aspects of service delivery. There was an up to date certificate of registration with CQC and insurance certificates on display as required. We saw the last CQC report was also displayed in the premises as required. CQC had received all the required notifications in a timely way from the service.
Further information is in the detailed findings below.