Background to this inspection
Updated
5 February 2020
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 team consisted of one inspector due to the small size of the service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 two people who used the service and one relative about their experience of the care provided. We spoke with six members of care staff including the registered manager, who was also the nominated individual, and three members of care staff.
We reviewed a range of records. This included two people’s care records, medication records and the audits in place to monitor the quality of the service. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and contacted two professionals who are regularly involved with people who use the service.
Updated
5 February 2020
About the service
Proactive Medicare provides personal care to people in their own homes. At the time of inspection, the service was supporting seven people, all of whom were receiving the regulated activity of personal care and living with complex health conditions.
People’s experience of using this service and what we found
Staff had received training to safeguard adults from potential abuse. Peoples identified individual health risks were assessed and managed safely in line with their personal preferences.
The registered manager had improved the recruitment process and staff had undergone pre-employment safety checks.
Staff managed medicines safely and the registered manager had regular oversight of this.
People who had complex needs were supported by knowledgeable and well-trained staff.
Staff ensured people had access to appropriate health care professionals when their needs changed.
People were supported to maintain their nutritional and hydration needs.
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.
Staff understood the principles of the Mental Capacity Act and people’s choice was promoted in all aspects of care.
Staff were caring, and the registered manager role modelled this behaviour.
People’s privacy, dignity and independence was respected.
People had person centred care plans which were updated on a regular basis.
The provider had a complaints process in place. Any complaints were investigated thoroughly, and the registered manager was open and transparent.
People received personalised care and support, informed by best practice guidance and in line with people’s personal preferences and goals.
People at the end of their lives and their loved ones, were supported well by compassionate staff.
The registered manager had systems in place to monitor the quality of care provided.
Staff told us the registered manager was hands on, warm and approachable. There was an open culture for staff and people to express concerns.
Healthcare professionals were very positive about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 15 November 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.