This inspection took place over three days commencing on 16 April 2018. The provider was given 2 working days’ notice of our visit. This was to ensure there was someone available at the office to speak with us. Home Fairy CIC is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community in Derby and Derbyshire and provides a service to adults. The majority of people, who use the service, receive services which are not regulated by the Care Quality Commission (CQC). For example, housework, gardening and support to access the wider community. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. At the time of our inspection there were seven people receiving personal care. The service operates between the hours of 8am and 6pm, all personal care and support is delivered between these times. The service has a minimum time set for staff to provide a service, which has been set at one hour.
Following the last inspection on 7 March 2017 we asked the provider to take action to make improvements in its staff recruitment practices. The provider submitted an action plan outlining their planned improvements and this action has been completed.
Home Fairy CIC 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.
The overall rating for the service awarded at the previous inspection which took place on 7 March 2017 was requires improvement at which time we identified a breach of the regulations. This inspection has found improvements have been made and the overall rating for the service has been revised to good.
The provider’s recruitment procedures ensured pre-employment checks were carried out on prospective employees to ascertain their suitability to work with people. We found there were sufficient staff employed to meet people’s needs, who had the appropriate training and support to delivery good quality care, which included tailored training to meet people’s health care needs.
Staff had undertaken training in safeguarding to enable them to recognise signs and symptoms of abuse and knew how to report them. Potential risks to the environment in which people lived had not been assessed, which meant there was potential for people using the service or staff. The registered manager took action by developing a form to record potential environmental risks and record the action to reduce the identified risk. Potential risks to people were assessed and plans were put into place to minimise risk, which staff understood and followed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s rights were upheld and decisions about their care were sought as part of the assessment process to identify their needs. The management team had focused on improving the involvement of people using the service or family members in the assessment process and development and review of care plans.
People’s health and welfare was promoted as staff supported people with the preparation and cooking meals. Staff liaised and worked with health care professionals to promote people’s health, which included providing support to people receiving end of life care and the management of individual health needs.
People received care from staff that in many instances had developed positive relationships. People’s communication needs were considered as part of the initial assessment process. People who were deaf were supported by staff who communicated with them in their preferred communication style, which included the use of British Sign Language.
The registered manager monitored the quality of the service provided by seeking the views of people who use the service and that of their family members. However people did not receive an overall analysis and any planned actions that would be taken in response to people’s collective comments. To further support quality monitoring staff had regular contact with the registered manager, who was available to provide support and guidance. Staff spoke positively about the service and the support they received from the registered manager.
Family members spoke positively about the service their relatives received, they told us they found the registered manager and staff to be approachable and they had confidence in the service provided. We received positive feedback from a commissioner as to the quality of the service.