Background to this inspection
Updated
1 August 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 was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses,flats and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary care service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 18 June and ended on 3 July 2019. We visited the office location on 18 June 2019.
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 work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection-
We reviewed four care plans, daily records and medicine records at the registered office. We also looked at three staff recruitment and training files. We reviewed a range of other documents including complaints, compliments, risk assessments and quality audits. During our time at the office we spoke with five staff, including the registered manager, care coordinators and a care worker.
We visited four people in their own homes to gain the experience of using the service. We also spoke with six people and two relatives via phone calls to gain their views and experiences.
We spoke to a further four care workers via phone calls to check their views of how well the service was being run.
After the inspection –
We asked the provider to send some further information about their training and quality monitoring processes. We followed up with one healthcare professional about an issue that had arose during the time the inspection was taking place.
Updated
1 August 2019
About the service
Chapter Care provides personal care to people in their own homes. They provide this care in the Barnstaple, Bideford, Ilfracombe and South Molton areas of north Devon. Not everyone who used the service received personal care. 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. At the time of this inspection the service provided care and support to approximately 140 people in their own homes.
People’s experience of using this service and what we found
People said they felt safe and well cared for. One person said, “They saved my life, I would not be here without their support.” Another person said, “They are generally very good, they have helped me out at a time of crisis, and they have never missed a visit.”
At the previous inspection we found recruitment needed some improvements. At this inspection we saw recruitment checks were fully implemented to keep people safe. Staff understood how to keep people protected from risks and what and who to report any concerns to.
Medicines were being managed safely and staff had training and support to ensure they completed this safely and effectively. Medicine records were monitored. There had been a recent safeguarding issue in relation to missed medicines, but this had been resolved.
Staff were knowledgeable and understood people’s needs, wishes and preferences. Staff had training and support to do their job effectively.
Where people needed support to prepare and eat meals and drinks, this was clearly indicated within care plans. Daily records showed what support people had received each day, including what drinks, food and snacks had been given or left for the person to have later.
There was sufficient staff for the number of visits required. This was closely monitored by the coordinators and care manager. New packages of care were only taken on if there was staff available to do this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were protected because risks had been assessed and any measures needed to mitigate these were fully documented.
People were supported where needed to maintain good nutrition. People’s health and emotional wellbeing was closely monitored and responded to when needed.
Staff were knowledgeable about people’s needs and wishes. People were treated with respect and their dignity and privacy was upheld.
The service had an open and inclusive culture, complaints were taken seriously. People and staff voice mattered, and the registered manager looked for ways to capture this.
There were quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.
Rating at last inspection – At the last inspection this service was rated good overall with requires improvement in Safe. (Report published January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk