Background to this inspection
Updated
19 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection comprised of one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
There was no registered manager in post. The service was run by a manager from a sister service who was to register with The Care Quality Commission.
Notice of inspection
We gave the service a 48 hours' notice of the inspection. This was because we needed to be sure that the management team would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who worked with the service.
The provider was not asked to complete a provider information return prior to this inspection. 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.
During the inspection
We spoke with five people who used the service and one person’s relative about their experience of the care provided. We spoke with the manager, the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. These included care and medicine records for five people. We looked at four staff files in relation to recruitment and staff supervision, and we examined a variety of records relating to the management of the service.
After the inspection
We contacted five members of staff to obtain their views on the quality of care provided to people. We continued to seek clarification from the provider to validate the evidence found. The provider sent us additional information we requested, and this was looked at as part of the inspection.
Updated
19 October 2019
About the service
1st Homecare is a domiciliary care agency that was providing personal care to 37 people at the time of the inspection. Not everyone using the service received personal care. The CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The service was exceptionally responsive to people's needs and immediately acted upon any occurrences. Staff went above and beyond the call of duty to provide individualised, person centred, high quality care. The service listened to people and implemented changes to the service to accommodate their needs and wishes. People and their relatives told us the service provided excellent care that exceeded their expectation.
The management and leadership of the service were exceptional. The management team had an excellent understanding of the provision of care and support for people with complex needs. There was an excellent culture within the service which promoted clear values and a drive to provide high quality care. The high quality, compassionate culture was embedded through every part of the organisation and ensured every person received exceptionally person-centred care.
People told us staff had enough time to support them and they had not experienced any missed visits. Staff were aware of what might be a safeguarding concern and explained how they would raise it. Risk assessments ensured people were supported to manage risks in their daily lives. There were systems in place to ensure people received their medicines safely. Staff were recruited safely.
Initial assessments were carried out to ensure people's needs could be met. These were used to produce personalised care plans and to guide staff on how to best support people. People were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff acted in people's best interests; the policies and systems in the service supported this practice. Staff had the right skills and experience to meet people's needs. A comprehensive induction and training programme were completed by all staff.
People and their relatives told us staff were caring, kind and polite. Staff treated people with dignity and respect. People and their relatives told us they felt able to express their views and had been involved in making decisions about people's care.
The provider had an up to date complaints procedure and people and their relatives told us they would know how to make a complaint if they needed to.
People, their relatives and staff were complimentary of management team. The provider had effective quality assurance systems in place which were used to drive improvements. The management team promoted a caring ethos at the service, which was supported by passionate and dedicated staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (21 March 2019).
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.