Background to this inspection
Updated
14 July 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
This was a targeted inspection prompted by concerns identified in a review of the information we held about this service. The areas of concerns we had were in relation to keeping people safe from abuse, infection control, consent to care and quality assurance systems.
Inspection team
One inspector carried out this inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was announced. We gave the service seven days’ notice in order to obtain information in advance of this remote inspection including contact details for staff and people who use the service.
Inspection activity started on 19 April 2022 and ended on 26 May 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 4 April 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
The registered manager provided evidence of the quality assurance systems and electronic call monitoring. We spoke with two care staff, two people who used the service and one relative. This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls and phone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. We spoke with the care manager on 26 May 2022. We spoke with the registered manager on 19 April, 5 May 2022 and 26 May 2022.
Updated
14 July 2022
This inspection took place on 27 and 30 October 2017 and was announced. The provider was given 24 hours’ notice because the location provides a personal care and nursing care service to people in their own homes and we needed to be sure someone would be in. One inspector carried out this inspection. At the time of this inspection there were eighty people using the service.
At the last inspection, on 28 and 30 December 2016, the service was rated Good overall and we found one breach of the regulations. This was because although the provider had systems to audit the quality of the service provider, they did not always document the outcome of these checks. At this inspection we found improvements had been made in this area. The provider now documented the outcome of quality audit checks.
There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manager 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.
Staff were knowledgeable about safeguarding and whistleblowing procedures when they suspected abuse. The service used an electronic system to monitor if staff were late or missed a visit. Safe recruitment checks were carried out. People had risk assessments done to ensure safe care was provided and potential risks were mitigated. There were systems in place to ensure people were supported to manage their medicines safely. Staff were supplied with sufficient quantities of personal protective equipment to prevent the spread of infections.
The registered manager and staff were knowledgeable about their responsibilities around the Mental Capacity Act (2005) and the need to obtain consent from people. Staff received support with training opportunities. Support was given to staff through formal supervisions in accordance with the provider’s policy but staff told us they would benefit from more frequent supervisions. The registered manager told us they offered informal supervisions to staff but these were not documented. Staff were aware of people’s nutritional and hydration needs. The provider liaised with relevant healthcare professionals and supported people to maintain their health.
People and relatives thought staff were caring and respected their privacy and dignity. Staff were knowledgeable about people’s care needs and preferences. Staff demonstrated awareness of equality and diversity, promoting people’s dignity and maintaining independence.
Care plans were personalised and contained people’s histories and preferences. Staff demonstrated awareness of providing personalised care. Complaints were dealt with appropriately and in line with the provider’s policy.
The provider has systems in place to obtain feedback from people who used the service and their relatives. People who used the service, relatives and staff spoke positively about the management of the service. Staff had regular meetings to keep them updated on service development.
We have made one recommendation around supporting staff. Further information around this can be found in the detailed findings below.