Integrated Crisis Response Service

Updated 11 April 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.

This inspection site visit activity started on 20 December 2017 and ended 22 December 2017 and was announced. This service provides personal care to people living in their own homes. It provide a service to older people, younger adults and children who may also have physical disabilities and other health conditions. We gave the service 48 hours’ notice of the inspection visit because the location provides domiciliary care service and we needed to be sure that someone would be at the office. This inspection was carried out by an inspector.

We reviewed the information we held about the service and notifications we had been sent. Notifications are changes, events or incidents that provider is required to send us by law. We contacted the health and social care professionals, Healthwatch Leicester and commissioners at Leicester City Council that find care for people to obtain their views about the service. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information to make our judgement.

The inspection was informed by feedback from questionnaires completed by 10 people who used the service, two relatives, three health care professionals and 21 Integrated Crisis Response Service (ICRS) staff. The responses and comments from all were very positive and reflected the commitment of ICRS staff to enable and empower people to be as independent and safe as possible in their own home.

We visited the service on all three days and also visited a person at home with a member of ICRS staff and spoke with their relatives. We spoke with seven people and seven relatives on the telephone to gather their views and experience of the quality of service provided. We spoke with the registered manager, care manager, 11 ICRS staff which consisted of assessors, coordinators and support workers. We spoke with six health care professionals who work with ICRS and the lead officer for Leicester Clinical Commission Group.

We looked at the care records for six people. These included care plans, risk assessments and records relating to the care and support provided by the service. We looked at recruitment and training records for four members of ICRS staff and records relating to how the service monitored the quality of service, complaints, meeting minutes and some policies and procedures.

We asked the provider to send statistical information about people’s ongoing support after their package of care provided by ICRS ended. We received the requested information. We sought the views of care providers that worked with ICRS when people’s package of care was transferred between services. The feedback we received about ICRS was positive.

Updated 11 April 2018

This inspection took place between 20 and 22 December 2017 and was announced.

Integrated Crisis Response Service (ICRS) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and supports family members such as children. At the time of our inspection there were 35 people using the service. The service was managed by the registered manager who employed a team of care coordinators, assessors and support staff and they worked with healthcare professionals to meet people’s needs. People’s packages of care varied dependent upon their needs.

This was our first inspection of the service since they registered with us on 27 April 2016.

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.

People were involved in decisions made about their care and influenced the frequency and level of support needed. People’s needs were assessed and risks were managed and monitored to ensure they received person centred care that helped them to achieve their independence and wellbeing.

The registered manager, care manager and staff team were highly motivated and demonstrated an excellent commitment to providing care which put people at the heart of everything. ICRS staff team worked with other health care professionals and ensured a coordinated approach in the delivery of care and support which had a positive impact on people’s quality of life.

Staff worked closely with health care professionals to provide joined up care to improve people’s quality of life and independence.

Staff were recruited safely. Staff were trained in safeguarding and other relevant safety procedures to ensure people were safe and protected from avoidable harm and abuse. Staff team knew how to keep people safe and report any concerns or incident. There were enough staff to support people.

Risks to people were assessed and effective and comprehensive care plans were put in place to minimise those risks. Staff were trained and knew how best to support people to reduce risk whilst they empowered people to be more confident to be as independent and safe as possible.

People and health care professionals without exception consistently spoke positively about staff’s professionalism, skills and knowledge in how they were supported. Staff worked flexibly to ensure people’s needs were met. Staff team were valued and well supported and supervised by the management team. Staff were encouraged to influence the development of the service and people’s care. Staff followed best practice guidelines that met people’s needs and successfully supported people with their independence to stay in their own homes.

People were supported with their medicines in a safe way and their health and dietary needs were met. Staff worked with health care professionals to ensure people healthcare needs were met. People were supported to access health care services when required.

People were involved and made decisions about all aspects of their care. They 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 told us staff were kind and caring. Staff had developed positive relationships with people, and valued each person as individuals. Staff knew how to maintain people's privacy and dignity and promoted people to be as independent as possible.

People spoke positively about the difference made by ICRS staff team which had an enhanced sense of well-being. Staff provided continuity of care and worked in a flexible way so that they could meet people's needs in a person centred way. People’s quality of life had improved because staff worked innovatively and in partnership with other healthcare professionals to enable people to live independently and meaningful lives. ICRS worked other departments such as health, social, housing, education and support services to ensure people received joined up care and support. Assistive technology and equipment such as telephone reminders, pendant alarms and equipment to promote people’s safety were easily accessible.

People knew how to make a complaint and were confident that their complaints and concerns would be listened to and action taken. People and staff had confidence in the registered manager and care manager, and both were approachable and supportive.

The registered manager provided leadership and was meeting their regulatory responsibilities.

The provider had effective systems in place to ensure people received safe and well organised service. Robust quality audits and checks were carried out to monitor the service, identify potential areas for improvements and action was taken to improve these.

People’s views and the opinions of their relatives and staff were sought in a number of ways and this was acted on. The management team ensured lessons were learnt and improvements were made within the service. They also influenced improvements made within the in-house departments and external services such as the hospital discharge team. This collective approach enabled the quality of service provided by ICRS and relevant healthcare professionals to be responsive and continuously drives improvements so that people who need urgent or crisis health and social care support.