Background to this inspection
Updated
5 October 2018
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.
The inspection activity started on 13 August 2018 and ended on 7 September 2018. It included telephone interviews with people who used the service and their relatives. We visited the office location on 7 September 2018, to see the registered manager and to review care records and policies and procedures. This was an announced comprehensive inspection completed by one inspector and an expert by experience. An expert by experience is a person who had personal experience of using or caring for someone who uses this type of care service.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
Before our inspection visit, the provider completed a Provider Information Return (PIR). 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 also reviewed information we held about the service in the form of statutory notifications received from the service and any safeguarding or whistleblowing incidents, which may have occurred. A statutory notification is information about important events, which the provider is required to send us by law.
We asked the local authority and Healthwatch for any information they had which would aid our inspection. We used this information as part of our planning. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion, which promotes the views and experiences of people who use health and social care services.
We spoke with 14 people who used the service and six relatives. We spoke with three care staff, the registered manager and the provider. We looked at the care and support plans for three people including assessments of risk and guidance for the use of medicines and quality audits.
Updated
5 October 2018
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of this inspection they were providing personal care for 75 people.
The Care Bureau Limited had a registered manager who was present on the day of our inspection visit. 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 inspection activity started on 13 August 2018 and ended on 7 September 2018. At our previous inspection in August 2015, we had no concerns and rated the service as Good. At this inspection we had concerns around the safety of the service.
People told us they felt safe using the service and staff knew how to safeguard them from the risk of potential abuse. People could be assured that any risks posed to them would be managed effectively to ensure their safety. Sufficient numbers of staff were provided to ensure people's assessed needs were met. People were supported by skilled staff to manage their prescribed medicines. Good hygiene standards and the use of essential personal protective equipment reduced the risk of cross contamination and infections.
The assessment of people’s needs ensured they received a service specific to their needs. Staff had access to training and supervision to enable them to provide people with a safe and effective service. Where needed people were supported by staff to eat and drink sufficient amounts to promote their health. The provider worked alongside other agencies to ensure people’s needs were met. People did not require support to attend medical appointments but where needed the registered manager would liaise with the relevant healthcare professionals to ensure people’s healthcare needs were met. People were supported to make their own decisions which were respected by staff.
People were supported by staff who were caring and attentive to their needs. People’s involvement in their care planning ensured they received a service the way they liked. People could be confident that their right to privacy and dignity would be respected by staff.
People and relevant agencies were involved in the care planning process to ensure people's specific needs were met and to promote equality and diversity. Complaints were listened to, taken seriously and acted on. The provider worked alongside relevant healthcare professionals to care and support people at the end of their life.
People were encouraged to have a say about the service they received and staff had the opportunity to share their views about the quality of the service provided to people. Staff said the registered manager was supportive. The provider’s governance was effective in assessing, monitoring and driving improvements where needed.