Background to this inspection
Updated
13 April 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one inspector.
Service and service type:
Paradigm is a domiciliary care agency, providing care and support to people in their own homes. They provide care to predominantly older people, including people living with dementia, physical disabilities and mental health needs.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 24 hours’ notice of the inspection because the service is small, and we wanted to ensure the registered manager would be available. We also wanted to arrange to visit some people using the service in their own home.
Inspection site visit activity started on 20 March 2019 and ended on 25 March 2019.
What we did:
Prior to the inspection visit we gathered information from a number of sources. We also looked at the information received about the service from notifications sent to the CQC by the registered manager. We requested the provider to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The registered manager completed a PIR prior to our inspection and we used this information to assist with planning the inspection.
We visited one person in their home. We discussed their care plan and observed staff interactions. We spoke with a further six people over the telephone to obtain their feedback. We also spoke with three relatives on the telephone.
We spoke with six staff including three care support workers, the care co-ordinator, a senior care worker and the registered manager. We looked at documentation relating to two people who used the service, two staff files and information relating to the management of the service. We also received feedback in writing from two commissioners.
Updated
13 April 2019
About the service:
Paradigm is a domiciliary care agency proving care and support to people in their own homes in the community. The service provides support to predominantly older people, including people living with dementia, mental health needs and physical disabilities.
At the time of our inspection 54 people were using the service.
People’s experience of using this service:
People told us they were safe. The providers processes and practices protected people from abuse. There were enough staff to ensure people’s needs were met. Recruitment procedures followed safe practices. Staff told us they were given time to provide care and support that was unrushed. People’s medicines were managed safely. Risks assessments were in place and risks were managed in a way that did not restrict people’s freedom. People were protected by the prevention and control of infection.
Staff supported people to make their own decisions and choices. Staff we spoke with were knowledgeable and understood the principles of the Mental Capacity Act 2005.
Peoples nutritional needs were met. People who required support with their diet had their needs met by staff that understood their dietary requirements. Staff received effective training to fulfil their roles and responsibilities and were well supported and supervised.
People spoke very positively about the care and support they received. People we spoke with told us staff were kind, caring and considerate. People also confirmed that staff maintained their dignity and respected them. People and their relatives said the staff were dedicated and passionate about providing good standards of care and support.
People received personalised care that was responsive to their needs. Care plans were detailed and developed with the people who used the service. The care and support plans included people’s decisions and choices. People were supported appropriately at the end of their lives.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. The registered manager kept detailed records of concerns that evidenced any issues were actioned promptly and satisfactorily.
People told us they were listened to and had opportunity to raise concerns if required. People we spoke with said they had no concerns at the time of this inspection. They said the service was excellent and if they had any issues no matter how small they were dealt with immediately by staff.
People’s feedback was used to make changes to the service.
The service had a registered manager who conducted a range of audits in areas such as, medicine management, health and safety, care plans and daily records documentation. We saw the monitoring identified areas for improvement and any actions raised as part of the audits were addressed.
More information is in the detailed report.
Rating at last inspection:
The service was last inspected in 2016 and was rated good.
Why we inspected:
This was a planned inspection based on the rating awarded at the last inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk