Knowsley and Liverpool East Office

Updated 7 February 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.

This inspection took place on 11 and 12 January, 2018 and was announced.

The provider was given 48 hours’ notice prior to the inspection visit. Prior notice is provided because the location provides a domiciliary care service and we needed to be sure that staff would be available on the day.

The inspection team consisted of one adult social care 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.

Before the inspection visit we reviewed the information which was held on Knowsley and Liverpool East Office. This included notifications we had received from the registered provider such as incidents which had occurred in relation to the people who were being supported. A notification is information about important events which the service is required to send to us by law.

A Provider Information Return (PIR) was not received prior to the inspection. This is the form that asks the provider to give some key information in relation to the service, what the service does well and what improvements need to be made. We also contacted commissioners and the local authority prior to the inspection. We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with a representative for the registered provider, two people who were being supported, two relatives and seven members of staff.

We also spent time reviewing specific records and documents, including four care records of people who were receiving support, four staff personnel files, staff training records, medication administration records and audits, complaints, accidents and incidents, health and safety records and other documentation relating to the overall management of the service.

Updated 7 February 2018

This inspection took place on 11 and 12 January, 2018 and was announced.

Knowsley and Liverpool East Office is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of the inspection the registered provider was providing support to 18 people.

At the time of the inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the registered provider was recruiting into the role of registered manager.

At the previous comprehensive inspection which took place in November, 2016 the registered provider was rated ‘Requires Improvement’. We found the registered provider was not meeting legal requirements in relation to ‘Safe Care and Treatment’ and ‘Need for Consent’.

During this inspection we found that a number of improvements had been made and the registered provider was complying with all health and social care regulations.

There were a number of different systems in place to assess and monitor the quality of the care being provided. This meant that people were receiving safe, compassionate and effective care. Such systems included weekly and monthly governance meetings, quality audits, care plan and medication audits as well as annual quality questionnaires.

Care plans and risk assessments which we reviewed were well maintained, regularly reviewed and updated in order to minimise risk and ensure the correct level of support was being provided.

Care plans were individually tailored to each person who was being supported and a person centred approach to care was evident throughout the inspection. Person centred means care which us tailored around the needs of the person, not the organisation. Staff were familiar with the support being provided and people’s wishes, choices and preferences were well known.

Medication management systems were being safely managed. Staff had received the necessary medication training. People had the relevant medication care plan and risk assessments in place which included detailed information about how medication administration needed to be supported.

Recruitment processes were reviewed during the inspection. All staff who were working for the registered provider had suitable references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enables the registered manager to assess level of suitability for working with vulnerable adults.

Staff received regular supervisions and annual appraisals. Staff expressed how they were fully supported in their roles; all necessary training had been completed and they felt that they were able to fulfil their roles effectively.

There was a system in place to monitor and assess all accidents and incidents. These were recorded on an internal database system, trends were analysed on a weekly and monthly basis which then helped the registered provider to establish trends and risks which needed to be managed.

The day to day support needs of people were well managed by the registered provider. Appropriate referrals were made when needed and the relevant guidance and advice which was provided by professionals was being followed accordingly.

The registered provider was aware of their responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with CQC’s statutory notifications procedures.

We reviewed a range of different policies and procedures which were in place. Policies and procedures were up to date, contained relevant information and were available to all staff as and when they needed them. Staff were familiar with the area of ‘safeguarding’ and ‘whistleblowing’ procedures. Staff knew how to report any concerns and had completed the necessary safeguarding training.