ASL

Updated 9 June 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.

We gave the service 48 hours’ notice of the inspection to ensure staff we needed to speak with were available and to enable the service to inform people the inspection was taking place and that they may be contacted. Inspection activity started on 3 May 2018 and ended on 8 May 2018. It included telephone calls to people and a home visit. We visited the office location on 8 May 2018 to speak with staff; and to review people’s care records and policies and procedures.

Prior to the inspection, we spoke with a commissioner of the service. During the inspection, we pathway tracked the care of four people. Pathway tracking is about capturing the experiences of a sample of people who use a service, by following the person’s route through the service and getting their views on it. We also looked at a further care plan and spoke with another five people about their care.

We spoke with four care and support workers, three team leaders and the registered manager. We reviewed three staff recruitment and supervision records. We also reviewed records relating to the management of the service.

This service had not been inspected since there was a change in the legal entity that provided the service and therefore it was due a comprehensive inspection. The inspection was also prompted in part by the notification of an incident. This is subject to investigation and as a result this inspection did not examine the circumstances of the incident. The inspection reviewed any potential on-going risks to people using the service who receive the regulated activity of personal care.

Updated 9 June 2018

The inspection took place on 8 May 2018 and was announced to ensure staff we needed to speak with were available. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. This service also provides care and support to people living in 12 ‘extra care’ houses, which are adapted single household accommodation. 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.

The agency provides a service to younger adults, older people, people living with dementia, people with learning disabilities or autistic spectrum disorder and people with a mental health diagnosis. They also provide care to people who misuse drugs and alcohol, people with an eating disorder, people with a physical disability or sensory impairment. The service provides care to 60 people, at the time of the inspection nineteen of these people received the regulated activity of personal care, therefore only their care was included within the scope of this inspection.

The service had a registered manager this 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.

Staff had undertaken relevant safeguarding training and understood their role to protect people from the risk of abuse. Potential risks to people had been identified, assessed and measures were in place to minimise the risk of their occurrence. People received their medicines from competent, trained staff. Relevant processes and procedures were in place to ensure people’s medicines were managed safely. People were protected from the risk of acquiring an infection. Processes were in place to review incidents and to identify any changes or learning required for people.

The provider operated robust recruitment procedures to ensure staff’s suitability to work with people. There were sufficient staff numbers of staff deployed to meet people’s needs and flexibility if people required additional care. Staff underwent an induction to their role and received on-going training appropriate to their role. Most staff had also achieved a professional qualification in social care.

Staff completed pre-admission assessments with people to determine if they could meet the person’s care needs. Staff had access to information about current standards, legislation and guidance to enable them to provide people with effective care.

Staff worked with a range of other statutory and non-statutory agencies in the provision of people’s care. Staff supported people to live healthier lives and to have access to healthcare services. People were supported where required to ensure they ate and drank sufficient for their needs.

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 reported they enjoyed positive, kind relationships with staff. Staff understood how to build relationships with people and spent time with them. People were encouraged to participate in making decisions about their care. People’s privacy and dignity were respected and promoted in the provision of their care.

People reported the service was responsive to their needs. People had care and support plans in place that identified their care needs and how these were to be met. Staff understood people’s care needs. Staff recognised that people living with a mental illness could find it more difficult to have a structure to their day or might experience social isolation and action had been taken to address this. People were provided with opportunities to participate in a range of activities, including in their local community. Staff had worked with other agencies to ensure people nearing the end of their life received appropriate care.

The registered manager promoted an open culture where people and staff felt able to speak to them about any issues as they arose. There was a clear management structure in place. Staff had a clear understanding of their role and individual responsibilities. People were provided with information about how to make a complaint. Any complaints received were logged and investigated in order to identify any areas of improvement for people.

People were very involved with the service. They worked jointly with staff on mental health awareness initiatives in the local community, fund raising and had input into the service via the service user representative and service improvement plan.

People their relatives and professionals had been sent a quality assurance survey to ask their views on the service and the responses showed there was a high degree of satisfaction. The registered manager and the operations manager also regularly audited the service in order to identify potential areas for improvement.