Background to this inspection
Updated
26 November 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 carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission who was also the provider. This means that they are 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 36 hours’ notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 22 October 2019 and ended on 28 October 2019. We visited the office location on 23 and 28 October 2019
What we did before the inspection
We reviewed information we had received about the service since the last inspection and sought feedback from professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 six relatives about their experience of the care provided. We also received two emails providing written feedback from two other people who used the service. We spoke with five caregivers, the care manager, three assistant care managers who were part of the internal quality team, the training co-ordinator and the community engagement director. We also spoke with the two owners who were the provider. One of the owners was the registered manager and the other was the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and three people’s medication records. We also looked at a variety of records relating to the management of the service such as quality checks, training information and the electronic monitoring system which supported the running of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We also spoke to one healthcare professional.
Updated
26 November 2019
About the service
I & J Williams Ltd is a domiciliary care agency that is part of the Home Instead Senior Care franchise. A franchise is a business in which the owners sell the rights to their business logo, name, and model to independent owners. The service provides personal care and companionship to older people living in their own homes. Some of these people were living with dementia. At the time of the inspection, 60 people received a service from I & J Williams Ltd, however, only 46 people 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
Caregivers were described as the 'heartbeat' of the service which was led by an inspiring provider who promoted a positive and inclusive culture. The provider was focussed on selecting caregivers with the right values through a rigorous recruitment process. Caregivers received excellent training and used their knowledge to make people's lives better.
People had a designated set of caregivers who provided all their calls and who knew them extremely well. Caregivers were able to notice any subtle changes in a person's health and seek immediate healthcare support.
People told us about the exceptional care and support they received from extremely kind and compassionate caregivers. They told us caregivers went out of their way to make their lives better. Caregivers were highly valued and exceptionally motivated to deliver high quality, person centred care. Relatives told us the reliability of the service was outstanding.
There was a clear dedication to providing high-quality person-centred care to people, so they could remain living in their own homes for longer. People and their relatives told us the service was exceptionally well led and they would recommend the service to others.
The registered manager had robust quality systems and processes in place to monitor and continually improve the service. The provider was passionate about being an active role model within its community and organised community events to enable people to live at home for longer. There was a clear dedication into making Dudley and South Sandwell dementia friendly.
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.
There was an open and honest culture with robust systems to manage complaints. People, relatives and caregivers felt comfortable to raise any concerns and had confidence these would be investigated thoroughly. However, everyone we spoke with told us they had no cause to complain.
There were robust systems and processes in place to manage risk and safeguard people from avoidable harm. People told us they felt completely safe when being cared for by I & J Williams Ltd.
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 26 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
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.