This inspection took place on 24 July 2017 and was announced. The provider was given 48 hours’ notice of the inspection because they provide domiciliary care and we needed to be sure someone would be in the office to facilitate the inspection. This was the first inspection undertaken at the service since registering with the Care Quality Commission (CQC) on 28 July 2015.The service provides care to people in their own homes. At the time of the inspection 28 people were receiving support of which seven people received personal care. We only looked at the service for people receiving personal care as this is the regulated activity that is registered with the Care Quality Commission (CQC).
At the time of our inspection, there was no registered manager in post. The service had a manager that had commenced in post 10 July 2017. They had commenced the process of applying to the Care Quality Commission (CQC) to register and their application was in progress. 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.
For the purpose of this report we have referred to care staff as caregivers in line with the services terminology when referring to care staff.
We found people’s care files were comprehensive, well organised and easy to follow. Risks to people’s health, wellbeing and safety had been assessed and plans formulated to mitigate identified risks.
The management of medicines promoted people’s safety. There was a detailed medicines policy and procedure in place that had been recently updated in line with best practice.
The service had a robust recruitment process to help ensure caregivers employed were suitable to work with vulnerable people.
There were sufficient numbers of caregivers deployed to ensure people's needs were met. Care and support was designed around the person and caregivers were recruited based on people’s needs. Caregivers were matched to the person they supported to promote positive relationships to develop.
Caregivers understood the Mental Capacity Act 2005 (MCA) and considered this when supporting people who lacked capacity to make certain decisions. People’s power of attorney (POA’s) were clearly identified in people’s care files so staff had access to the required information.
Caregivers were passionate about the care they provided and spoke fondly of the people they supported.
Support plans were person centred and caregivers had a comprehensive knowledge of people and their needs which demonstrated a commitment to people receiving person centred care. People were encouraged and supported to pursue their individual hobbies and interests and caregivers actively sought opportunities to promote people’s independence.
Management demonstrated a commitment to caregivers to continue their professional development to maintain skills and deliver best practice. Caregivers were supported through induction, supervision and training to promote better outcomes for people.
People who used the service were fully involved with decisions about their care and we were told they were given choices in relation to their care delivery and their personal preferences were taken into account.
There was a complaints policy in place and although at the time of the inspection there had not been any complaints received, there were systems in place to track complaints.
Feedback was sought from people, relatives and caregivers through surveys and quality assurance systems.
Leadership was strong and management demonstrated a clear vision of what was required to provide a quality service. The service worked in partnership with other agencies and people were signposted to community services to promote better outcomes for people receiving support.
Audit systems were effective and in place to monitor the quality of the service delivered.