Background to this inspection
Updated
18 August 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was a comprehensive inspection and was carried out by one inspector. The inspection took place on 30 June and 7 July 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be available.
Before the inspection we reviewed the information we held about the home. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners of the service.
The provider completed a provider information return (PIR) prior to the inspection. 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.
We spoke with six people living at the service and two relatives. We also spoke with the care team leader, a senior care assistant and four care assistants. We looked at a range of records which included the care records for three people, medicines records for three people, recruitment records for three staff, supervisions, appraisal and training records. We also looked at a range of other records related to the quality and safety of the service.
Updated
18 August 2017
This inspection took place on 30 June and 7 July 2017 and was announced. This means the provider knew we were coming. At the last inspection on 3 and 6 May 2016, the service was rated requires improvement. We also found the provider had breached the regulations in relation to safe care and treatment, the need for consent, staffing and person-centred care.
The service provides an on-site domiciliary care and support service to people who are tenants within Seafarers Way extra care scheme. The scheme is aimed at people living with dementia. The scheme can accommodate up to 38 people. At the time of our inspection there were 35 people receiving a care service.
The service had a registered manager. 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.
Since our last inspection the provider had improved the effectiveness of the risk management processes in the service. Where a potential risk had been identified a risk assessment had been carried out to help keep people safe.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Best interest decisions had been made on behalf of some people using the service. Care staff were not following current good practice by not always documenting a Mental Capacity Assessment in respect of these decisions. We have made a recommendation about this.
A new format for assessing people’s needs and support planning had been introduced. This prompted staff to gather information about people’s needs and preferences. This information was used to develop detailed and personalised support plans for each person. Support plans were reviewed in line with the provider’s expectations.
People were happy with the care they received and said staff were kind and caring.
Previous safeguarding concerns had been dealt with in line with the provider’s procedures.
Medicines records were accurate and accounted for the medicines people had received. Staff were trained and assessed to confirm they were competent to administer medicines. Medicines audits were effective in identifying issues relating to medicines.
There were effective recruitment processes to ensure new staff were suitable to work with people using the service. For example, requesting and receiving references and checks with the disclosure and barring service (DBS).
Incidents and accidents were logged and monitored to ensure action had been taken to keep people safe.
A business continuity plan had been developed to guide staff through how to deal with emergency situations.
Staff received the training and support they needed. Records confirmed training, supervisions and appraisals were up to date when we inspected the service.
One complaint received had been investigated and resolved in line with the provider’s complaint procedure.
People and staff had opportunities to give feedback and share their views about the service. Regular staff meetings took place and questionnaires were sent out to people to gather their views. The provider had received positive feedback about the service.
There were effective systems in place to check on the quality of people’s care. These included checks of falls, complaints, medicines, people’s daily records and support plans. A senior manager also regularly carried out checks of the service.