Background to this inspection
Updated
31 January 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 was planned to check 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 service is a domiciliary care agency. It provides personal care to people living in their own homes.
Before the inspection we reviewed information that we held about the service to inform and plan our inspection. This included information that we had received about the service as well as statutory notifications that the provider had sent to us. A statutory notification contains important information about certain events that they must notify us of. We contacted the local health commissioners who had funding responsibility for some of the people who were using the service.
We used information the provider sent us in the 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.
The inspection visit took place on Wednesday 17 January 2018 and was announced. The provider was given 48 hours’ notice of our visit. This was because the location provides a small domiciliary care service and we wanted to be sure staff would be available to meet with us as part of the inspection visit.
There were eleven people who received personal care from the provider at the time of our inspection. The service was inspected by one inspector.
During our visit to the location we spoke with four staff, the provider, the administrator, and the care co-coordinator. We also looked at the records of three people who used the service, and records related to quality and safety. On the day after our visit we spoke by phone with two people who used the service, and seven relatives of people who used the service.
Updated
31 January 2018
This inspection took place on 17 January 2018 and was announced. At our last comprehensive inspection in November 2016 the service was in breach of four legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were Regulation 12, Safe care and treatment; Regulation 18, Staffing; Regulation 19, Fit and proper persons employed; and Regulation 17, Good Governance.
Following the comprehensive inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of ‘Safe’, ‘Effective’ and ‘Well-Led’ to at least ‘good’. In January 2017 we went back to the service to do a ‘focused’ inspection to check people who used the service were safe. We saw at the focused inspection improvements had started to take place. During this inspection we found the service had continued to improve and there were no longer any breaches in the Regulations.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our visit it provided care to 11 adults. We spoke with two people and seven relations.
The service had a registered manager. 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.
The service provided care to a much smaller group of people than during our last comprehensive inspection visit, and with a reduced number of staff working at the service. There was a new office team and management structure. The office and management team were clear about their roles and responsibilities and worked well together to improve the service provided to people. Staff told us they enjoyed working for the service, and felt supported by the office and management staff.
Management had reflected on where they had gone wrong in the past, and had put measures in place to make sure they identified issues quickly so they could be rectified at an early stage.
Care records had improved since our last inspection. They now provided staff with clear information about the risks related to people’s care and how they could best minimise these when delivering support to people. People’s care needs were regularly reviewed, and the office was in regular contact with people or their relatives to check care provided was what people wanted and expected. Most people felt the office and management team listened to them and dealt with any concerns they had.
Most people and relatives of people who used the service told us they received care from staff who were kind, friendly and knew how to support them. People’s dignity and privacy was respected by the staff who supported them. Food and drink was provided in line with people’s requests.
Most people told us care workers arrived at the time expected, and undertook the care tasks as outlined in their care plan.
People felt safe with the care workers who supported them. Recruitment practice had improved since our last visit, and now all pre-employment checks had been carried out before staff started to work for the service.
Care workers understood the Mental Capacity Act, and the importance of gaining people’s consent before delivering care. 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.
Staff made sure they used protective clothing when proving personal care to reduce the risk of infection being passed from one person to another.
People who were supported with medicines, received their medicines from staff who had been trained to administer them. Medicine records had improved since our last inspection, and now informed staff of the reasons why people were prescribed their medicines. Medicine checks ensured staff administered medicines correctly. Staff worked well with health care professionals when required.
Staff training had improved since our previous inspection. Staff received training to support their skills and knowledge to provide effective care. They received regular individual support sessions from senior staff. Senior staff also undertook unannounced checks at people’s homes to ensure staff provided care to an acceptable standard.