Background to this inspection
Updated
22 December 2017
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 took place on 24 and 27 November 2017 and was announced. We gave the service 48 hours’ notice of the inspection visit because it we wanted to be sure the registered manager would be present. We also wanted to give the service sufficient time to agree with people that would could visit them or contact them by telephone to find out their views on the service. This is the first inspection of the service since it was registered on 22 July 2016.
The inspection was carried out by one inspector.
We visited the office location on 24 November 2017 where we met with the registered manager, the regional manager, and three members of staff who were mainly based in the agency office. We reviewed four care records, medicines administration records, staff recruitment and training files, and policies and procedures. During our visit to the office we also met two care staff who were visiting the office that day and a health care professional. On 27 November we visited four people who received a service in their homes. We also contacted three people by telephone on 28 November 2017 and one member of staff.
Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also sent out questionnaires to people who use the service, relatives and community professionals. We received responses from 23 people who used the service, one relative and one community professional. We also received one compliment from a relative who completed a ‘Have your say’ form.
Updated
22 December 2017
This inspection took place on 24 and 27 November 201 7 and was announced. This is the first inspection of the service since it was registered on 22 July 2016.
Guinness Care At Home Plymouth is a domiciliary care agency. It provides personal care to older adults and younger disabled adults living in their own houses and flats in the community, including Douro Court and Bishops Court. At the time of this inspection approximately 80 people received a domiciliary care service in their own homes in the community and 38 people living in extra care housing received personal care. People living in Douro Court and Bishops Court received a specialist service that is known as ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
There was a registered manager in post. 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 received a service that was safe. Comments from people who used the service included “Yes, I feel very safe”. Improvements had been made to the service in recent months to ensure people received a reliable service at the times they had requested, and from a small team of care workers they knew and trusted. The likelihood of late or missed visits had reduced significantly because there were effective systems in place to plan care and track care workers’ visits.
People were safe from harm because staff had received training and information on safeguarding and knew how to identify and report any concerns. Care was taken when recruiting new staff to ensure they only employed staff who were trustworthy, reliable and entirely suitable for the job.
Care workers had received training on safe administration of medicines and there were good systems in place to ensure people received their medicines safely. Checks and audits were carried out regularly to identify risks or errors and actions were taken to improve the safety of medicine administration where necessary.
People were protected from the risk of infection. Care workers had the knowledge and equipment needed to ensure people were protected from infection. Spot checks were carried out by the management team to ensure care workers followed safe infection control procedures.
People received an effective service from capable and skilled care workers. Comments from people who used the service included, “The girls have been brilliant!” and “You can’t fault them at all.” Care workers received thorough training, supervision and support to ensure they had the right skills to meet peoples’ needs. Care workers were given ongoing training and regular updates on a range of topics relevant to people’s needs. The training ensured care workers understood how to keep themselves and the people they cared for safe and free from harm. Care workers had access to advice and support at all times of the day and night.
Before people began to receive a service their needs were assessed. A plan of their care needs and any risks associated with their health or personal care was drawn up and agreed with them. Care workers had good information about how to support people to keep them safe and reduce any risks. Care workers were also given information and training to ensure they supported people’s right to make decisions about their lives. This ensured they followed the principles of the Mental Capacity Act 2005 (MCA) at all times.
People received a service that was caring. A person told us care workers were “really caring, special.” Care workers talked about the care and compassion demonstrated by the management team. “The bosses are brilliant! A really compassionate team” and, “They care so much!” People told us care workers were caring, compassionate and kind. People were treated people with dignity and respect. Care workers knew each person well and ensured people were involved and consulted about the care they received. Care workers understood their role to help protect people’s equality, diversity and human rights.
People received a service that responded to their needs and any changes in their health or personal circumstances. A person told us “They automatically know what they have to do. They are very experienced carers. They know me and I know them.” People were involved and consulted about the care. They were given a range of information about the service, including regular timetables, to ensure they knew who would be visiting and when. Information was presented in a format to suit their individual needs. Care workers understood each person’s individual needs, daily routines and preferences.
People were confident any comments or complaints would be listened to, investigated and actions taken to prevent recurrence.
People received a service that was well led. Where the provider had identified problems and concerns they had taken a range of actions to improve the management of the service. Care workers told us the improvements had been positive. Comments included, “Strong, strict but fair management”, “Management is a lot, lot better” and “I can see an improvement.” The registered manager and their management team were well respected and provided effective leadership. There was an open, caring management style and care workers felt valued. There was a strong sense of job satisfaction and pride in providing a high standard of care.
The provider and registered manager had a range of quality monitoring systems to identify good practice and areas for improvement. The visions and values of the service were clearly communicated and followed by staff. The registered manager notified the Commission of significant events which had occurred in line with their legal obligations.