This inspection took place on 12 and 13 June 2017 and was announced. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office. This was the first inspection carried out at this location since the provider registered this service as a new location on 23 June 2016.Care At Home - Berkshire is a domiciliary care service providing personal care to people in their own homes. At the time of our inspection 49 of the 80 people receiving a service were living in their own flats in extra care housing. Thirty one people were living in their own homes in the community.
By extra care housing, we mean purpose-built (or purpose adapted) single household accommodation that is owned or occupied under an occupancy agreement. The accommodation is in a building or campus of similar households specifically designed to facilitate the delivery of care to people, either now or when they need it in the future. There are three extra care facilities where the service provides personal care to those who need it. The provider also staffs each of the three extra care facilities with a 24 hour care worker presence in case people require additional help outside their scheduled call times. This 24 hour staffing arrangement is between the provider and the local authority and is outside our regulatory remit. The accommodation and any other additional services provided at the facilities are also outside the remit of the Care Quality Commission. Only the provision of personal care is registered and inspected.
Up until 22 June 2016 the three extra care facilities were registered as separate locations. On 23 June 2016 the management of the provision of personal care at all three extra care facilities moved to the provider's head office and became one service. The provider also had a separate service providing personal care in people's own homes in the community, called Care In The Home. The management and provision of personal care to the people using that service was transferred to Care At Home – Berkshire on 20 February 2017. Care In The Home was inspected in November 2016 and achieved a rating of Good before merging into Care At Home – Berkshire. This part of the service was not inspected at this inspection as it was only six months since they were inspected as a separate service. The report from that inspection is available on our website.
The service had a registered manager as required. A registered manager is a person who has registered with the CQC 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 registered manager was present and assisted us during this inspection.
People were treated with care and kindness. They were consulted about their support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by people we spoke with and relatives who provided feedback.
People were protected from the risks of abuse. Some staff recruitment issues were identified by us during the inspection, but were dealt with by the registered manager immediately following the inspection. People and their relatives confirmed people were encouraged and supported to maintain and increase their independence.
People received effective care and support from staff who knew them well and were mostly well trained. We have made a recommendation about ongoing staff training.
People received effective health care and support. Medicines had not always been handled correctly and safely with a number of medicine errors over the past 12 months. The provider was aware of the issues and agreed to take further action to improve the safety of the handling of medicines. We have made a recommendation about the management of medicine errors.
People's rights to make their own decisions were protected. People 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's diversity needs were identified and incorporated into their care plans. People's right to confidentiality was protected and they received support that was individualised to their personal preferences and needs.
People and their relatives knew how to complain and knew the process to follow if they had concerns. They confirmed they felt the staff and management would act upon any concern raised.
Staff told us they were happy working for the service and people benefitted from staff who felt well managed and supported. People and their relatives thought the service was well-led, which was also stated by health and social care professionals.
The service was mostly managed well but there was no effective system for the registered manager to ensure the service was fully compliant with the fundamental standards (Regulations 8 to 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). You can see what action we have asked the provider to take in the full version of this report.