We carried out an unannounced inspection of the service on 9 June 2015. At our previous inspection on 17 February 2014 we found that the service was in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which following legislative changes of 1st April 2015 corresponds with Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found then that staff had not always sought people’s consent in accordance with the requirements of the Mental Capacity Act (MCA) 2005. After our inspection the provider sent us an action plan setting out what they would to address the breach of regulation.
At this inspection we found that the provider had made the necessary improvements and now met this regulation.
The service provides care and support for over 200 people who live in their own homes. The service had 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.
People using the service were safe. They told us they felt safe because they were mostly supported by the same care workers who were knowledgeable about their needs. They knew which care workers would be visiting them which made them feel secure. Care workers knew how to recognise and respond to signs that a person was at risk of abuse.
People’s care plans included assessments of risks associated with their care and support. Care workers used the information to support people safely.
The provider effectively deployed care workers so that people received visits when they needed. They had robust recruitment procedures to ensure as far as possible that only staff suitable to work with the service were employed.
People were supported to take their medicines by care workers who had received training in medicines management.
Care workers were supported through training and supervision to be able to meet the care needs of people they supported. Staff who arranged home visits took care to ensure that people with cultural needs were supported by care workers with the same cultural background if that is what they wanted.
Care workers understood their responsibilities under the Mental Capacity Act 2005. They sought people’s consent before providing care and support. They were attentive to people’s nutritional and heath needs.
Care workers developed caring relationships with people because they supported the same people and grew to know them and understand their needs and preferences. People were involved in decisions about their care and support. They told us that care workers respected the choices they made and treated them with dignity and respect.
People received care and support that was centred on their individual needs. Their care plans included information about their needs and how they wanted to be supported. The care plans were referred to by care workers.
People and staff were involved in the development of the service because their views were sought and acted upon. People and staff felt the service was well managed. The service was well organised and led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009. The provider had effective arrangements for monitoring and assessing the quality of the service.