Care at Home

Updated 16 July 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by two inspectors.

Service and service type

Care at Home is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Care at Home also provides care and support to people living in 12 supported living households, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is 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 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or service manager would be in the office to support the inspection.

Inspection activity started on 10 June 2019 and ended on 13 June 2019. We visited the office location on 10 June and 13 June 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and five relatives about their experience of the care provided. We spoke with 11 members of staff including four service managers, two senior care workers and five care workers.

We reviewed a range of records. This included 14 people’s care records and multiple medication records. We also spoke with two healthcare professionals who were working with the service. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 16 July 2019

About the service

Care at Home is a domiciliary care service which provides personal care and support to people with physical needs as well as people who have mental health needs, sensory impairments and learning disabilities. The care and support are provided to people who live in their own homes and also to people who live in supported living accommodation. The level and amount of support people receive is determined by their own personal needs.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People's independence was respected and promoted and the support provided to people focused on them having opportunities to maintain existing relationships.

People received a consistent level of care from a team of regular care workers. There were enough staff employed to meet people's needs.

Staff communicated with people effectively to ascertain and respect their wishes. People could decide how and when their care was provided. Safe recruitment practices were followed to protect people from unsuitable staff.

People were supported to access other health services when needed. People's care plans provided staff with information about people's preferences and ways in which staff could support people emotionally and with the activities they enjoyed.

People were protected from abuse and harassment and received appropriate support to take their medicines safely as and when required.

The provider had arranged training for staff that met the needs of people using the service. Staff competency was assessed which helped to ensure they were safe to work with people.

The provider had ensured there was effective oversight and governance of the service. The managers of the service worked alongside staff and any concerns in relation to the quality of support were identified and acted upon promptly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 13 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.