Belong at Home Domiciliary Care Agency - Wigan

At our last inspection we rated the service good. At this inspection we found the 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. At this inspection we found the service remained Good.

People who received support from Belong, and their relatives, continued to tell us they had trust in the staff and felt safe when staff supported them in their own homes.

Policies in relation to safeguarding and whistleblowing reflected local procedures and relevant contact information.

Systems were in place to identify and reduce the risks to people living in their own homes.

Accidents and incidents were managed appropriately.

A robust recruitment and selection process was in place and staff had been subject to criminal record checks before starting work at the service.

Medicines were managed safely and people received their medicines as prescribed by their GP.

People continued to tell us support staff had the knowledge and skills needed to provide an effective service.

There continued to be a focus on delivering training to all staff; where necessary training was in keeping with the requirements of the Care Certificate.

Support staff continued to receive regular supervision and more often, for example, during the induction period.

The service ensured that support staff were matched with people who used the service to ensure they were happy and comfortable with them providing support.

We saw health and wellbeing support plans were completed which identified the level of support people needed to access health appointments

There remained a strong emphasis on the importance of people eating and drinking well. Before any care and support was provided consent was obtained from the person who used the service.

The service worked within the principles of the Mental Capacity Act 2005.

People continued to tell us support staff were kind and caring and treated them with dignity and respect.

People's care plans showed an assessment of their needs had been undertaken by the service before any care and support was provided; people confirmed they had been involved in this initial assessment.

We found the provider was meeting the requirements of the Accessible Information Standard.

People who used the service had support plans in place with copies continuing to be held at both the head office and in their own homes; the structure of the plans was clear and it was easy to access information which provided support staff with clear guidance on people’s individual support needs.

People told us they had never had cause to complain about the service they received.

We saw historical positive feedback had been received from people who used the service and their relatives.

People continued to be routinely supported to access the community and to pursue their hobbies or interests.

The service did not deliver end of life care directly but could do so with the support of relevant professionals such as district nurses where applicable. At the time of the inspection the service was not providing end of life care to anyone.

There was a registered manager in post. 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.

The registered manager was very visible in the team and proactive throughout the inspection.

There was an open culture which empowered people to plan and be involved in the high-quality care provided at this service.

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.

We found the service had been accredited with Investors in People (IIP) recognition to Gold standard.

CQC had received all the required notifications in a timely way from the service.

Further information is in the detailed findings below

The service was last inspected on 12 June 2013 and was meeting all the regulations assessed at that time.

Belong at home was based within the Belong care village, Wigan. Belong villages offer four key services; households offering 24 hour care, apartments which can be bought or rented privately where people continue to live independently, a village centre with a range of facilities open to the public and Belong at home domiciliary care, which goes out in to the wider community to support people in their own homes.

Belong at home domiciliary care Wigan provides domiciliary care services to people who live in their own home. At the time of our inspection there were 45 people receiving support. People receiving support had a range of different health care needs, including people living with a diagnosis of dementia.

There was a registered manager in post. 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.

The registered manager was passionate about making a difference to people and was committed to supporting people living with dementia and also their families. They had received a National award in recognition of their work. Their values and commitment to providing high quality care were shared by the staff team which was demonstrated through the feedback received from people and their relatives.

People were actively encouraged to be part of their community. People from the local community, and professionals were also welcomed in to the care village. The registered manager had been involved in the development of support services within the care village to provide a forum for sharing knowledge and increasing awareness of support to people living with dementia.

There was a positive, open, caring culture, which was promoted by the registered manager. Staff reported feeling supported by the registered manager, describing them as approachable, knowledgeable and understanding.

People and their relatives were consistently complimentary about the care and support received. People spoke highly about the registered manager and staff. People told us they thought of the staff as friends and family. It transpired throughout the inspection that people valued having staff that were consistent and with whom they had built relationships. People and their relatives spoke positively about the skills of the staff and felt staff were efficient, well trained and went the ‘extra mile’ to ensure people felt they mattered.

People had positive relationships and there was a strong emphasis on key principles of care such as; compassion, respect and dignity. People who used the service felt they were treated with kindness and said their privacy and dignity was always maintained and respected.

Support plans were person centred and staff had a comprehensive knowledge of people and their needs which demonstrated a commitment to people receiving person centred care. People were encouraged and supported to pursue their individual hobbies and interests. People made excellent use of the care village facilities and staff were innovative in recognising and supporting people’s individual needs.

We found the service had an up to date policy and suitable safeguarding procedures in place, which were designed to protect vulnerable people from abuse and the risk of abuse. We reviewed a sample of recruitment records, which demonstrated that staff had been safely and effectively recruited.

We considered the Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS) and obtaining consent from people. There was nobody in the service subject to a court order. Staff demonstrated a good understanding of obtaining consent, best interest decisions and least restrictive practices.

Feedback was sought from people, relatives and staff through meetings, surveys and quality assurance systems.

Leadership was strong. Management had a clear vision of what was required to provide a quality service. All the staff we spoke with were respectful of management, felt involved and demonstrated a commitment to working towards the shared values.

People said staff gave them the attention they required without interfering with peoples lives.

Staff spoken with demonstrated their understanding of peoples needs and of how to provide needs led care and support to the people who used the service.

Care records showed that people's individual needs and preferences had been taken into account and that people had been given a choice in how they wished to be cared for.

Care records showed that a person's independence was actively supported. Staff were knowledgeable about a person's care and gave examples of how they treated people with respect and dignity and promoted people's independence.

All necessary checks to safeguard people against abuse had been undertaken in the employment of staff and a regular training programme for all staff ensured they had the qualifications, skills and experience to undertake personal care.