We undertook an announced inspection of Oxford Aunts Domiciliary Care Agency (DCA) on 9 November 2015. We told the provider two days before our visit that we would be coming. Oxford Aunts provides personal live in care services to people in their own homes. At the time of our inspection 84 people were receiving a personal care service.
There was a registered manager in post. 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.
People we spoke with told us they felt safe. People were supported by staff who could explain how they would recognise and report abuse. Risks to people were managed and reviewed. Where people were identified as being at risk, assessments were in place and action had been taken to reduce the risks.
People benefitted from staff who understood and implemented the principles of the Mental Capacity Act (2005). The MCA is the legal framework to ensure that where people are assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests. Care staff we spoke with had completed training on the MCA.
There were sufficient staff deployed to meet people’s needs and staffing levels were matched to the individual needs of people. Records relating to the recruitment of new staff showed relevant checks had been completed before staff worked unsupervised at the service.
Where people needed support with medication we saw that records were accurately maintained and fully completed which showed people received the medicine they needed when they needed them. People who needed assistance with their medicine were supported appropriately by trained staff.
People told us staff knew their needs, supported them appropriately and had the skills and knowledge to carry out their roles and responsibilities. Staff received regular supervision and had access to development opportunities.
People and their relatives spoke highly of the care that was delivered by the service. Staff we spoke with knew the people they were caring for and supporting, including their preferences and personal histories. People were supported to maintain their faith and religious needs.
People told us they felt involved in their care. People’s needs were assessed prior to receiving care to ensure their needs could be met and people received personalised care. Care records contained details of people’s personal histories, likes, dislikes and preferences. The service sought the advice and worked with healthcare professionals to meet people’s needs.
The service sought people’s opinions through a yearly satisfaction survey and a quality assurance questionnaire following each placement. Where people raised issues the service took action to improve the service.
There was an open and caring culture and staff spoke positively about the registered manager and care managers. Accidents and incidents were recorded and investigated. Information was logged onto an ‘Improvement diary’ allowing the registered manager and senior staff to review this information collectively to look for patterns and trends across the service. Information was used to improve the service.
Regular audits were conducted to monitor the quality of service. These were carried out by the provider. Audits covered all aspects of care including, care plans and assessments, risks, staff processes and training. Information was analysed and action plans created.