Background to this inspection
Updated
30 March 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 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.
This inspection took place on 16 January 2018 and was announced. We gave the service short notice of our inspection to ensure the registered manager was available to assist us. The inspection was undertaken by two adult social care inspectors and an expert by experience in the care of older people, people living with a dementia and people who have a learning disability, people who have a dual diagnosis of learning disability and mental health and people with autism. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
To understand the experiences of people who used the service we spoke with nine clients, two family members and received feedback from one community professional. We also spoke with four care givers, the registered manager and both directors of the service, one of which was a second registered manager and the other the nominated individual.
During our inspection we checked a number of records relating to the management and delivery of care of the service. These included five care files, five care givers files, audits and quality monitoring, duty rotas and feedback.
Prior to the inspection we looked at the information we held about the service. This included feedback, enquiries and statutory notifications which the provider is required to send to us by law. We also checked the Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
Updated
30 March 2018
The inspection took place on 16 January 2018 and was announced. We gave the service short notice of the inspection. This was because we needed to be sure the registered manager would be available to support us. This was the first inspection since the service was registered with the Care Quality Commission on 21 December 2016 at their new location. The service had been previously inspected on 3 September 2016 at a former address and was rated as good overall. However, well led was rated as requires improvement. This was because systems and processes were not operated effectively to ensure compliance. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question ‘well led’ to at least good. During this inspection we found the service was meeting the requirements of the current legislation.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It delivers a service for older people, younger adults, sensory impairment, physical disability, people with learning disabilities or autistic spectrum disorder and people living with a dementia. One of the registered managers told us people who used the service liked to be known as clients and staff liked to be known as care givers.
The service had two registered managers in post at the time of our inspection. 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.
Care givers understood the procedures for reporting any allegations of abuse. Systems to record and investigate any allegations were in place. Detailed risk assessments had been completed that guided care givers on how to manage any potential risks safely.
Duty rotas confirmed appropriate levels of care givers were in place to deliver clients care. Safe recruitment practices were in place that demonstrated only suitable people were employed by the service. A robust training programme was provided for all of the care givers. This ensured they had the knowledge and skills to deliver effective 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 of the service supported this practice.
The service worked closely with the wider professional team to support positive health outcomes for clients. Clients and relatives were happy with the care they received and told us care givers treated them with dignity and respect. Records we looked at identified clients likes, dislikes and choices in relation to the care they received. Care records were detailed and comprehensive and reflected clients individual needs. Assessments of care had been completed.
Where clients were supported at the end of their life care givers were selected according to their skills and expertise to deliver appropriate care.
Complaints procedures were in place and records included lessons learned to improve the service for clients. There was evidence of regular audits and monitoring of the service that ensured clients received good quality care.
There were numerous examples of positive feedback received about the service that demonstrated the quality of care clients received. Minutes from team meetings were seen and care givers and clients newsletters were regularly developed to provide updates about the service.