Background to this inspection
Updated
12 March 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with ten people who used the service and three relatives about their experience of the care provided. We visited four people in their own homes. We spoke with eleven members of staff including the registered manager, governance manager, two care managers, seven care workers and the training manager.
We reviewed a range of records. This included eight people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with four professionals who regularly had contact with the service.
Updated
12 March 2020
About the service
SPDNS is a domiciliary care agency which offers nursing care, personal care, end of life care and companionship to support people living in their own home. At the time of this inspection the service was supporting approximately 90 people with personal care.
Not everyone who used the service received 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.
People’s experience of using this service and what we found
The registered manager had developed excellent links with local charities, hospice teams and health and social care professionals and this enhanced the quality of people’s lives.
The service had strong vision and values which placed the importance on people being fully involved in all aspects of care, where independence was promoted.
People told us staff were outstandingly caring, proactively identifying unmet needs and supporting these to be met in creative ways. They told us staff often going the extra mile to support them.
People were protected from abuse by staff who had a good understanding of how to protect vulnerable adults.
Medicines were managed safely. Care managers carried out comprehensive assessments of people’s needs and risks to people’s health were identified and managed safely in line with people’s preferences.
The service made sure there were enough staff in place to manage people’s needs. All staff had undergone a robust recruitment and induction process to ensure they had the skills needed to care for people well.
Staff promoted people’s independence in line with people’s choices. People who lacked capacity to make decisions had undergone appropriate assessments involving loved ones and other nominated people such as power of attorney for health and welfare.
Staff made sure people had access to fluids when they were not present. All staff had been trained in good food hygiene.
The service provided an excellent training programme to staff by a dedicated training manager. People commented staff had the right skills. Additional training was sourced when needed.
Care plans were task orientated, however small care teams which knew people well, ensured care provided to people was person centred and daily notes demonstrated this.
Staff supported people to maintain relationships with loved ones, and the local community to avoid social isolation.
The registered manager had robust systems in place to manage complaints. People told us they felt confident that any concerns would be managed well.
Staff were trained in end of life care. The service worked alongside carers groups to offer respite to loved ones. This meant people were supported to remain at home if they wished.
Staff and people told us the service was well managed.
Robust governance processes were in place which informed the quality of the service and when improvements were needed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Rating at last inspection
The last rating for this service was good (published 10 January 2017).
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.