Background to this inspection
Updated
3 February 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.
This was a comprehensive inspection which took place on 11 and 12 December 2017, it was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We therefore needed to be sure that someone would be available in the office to assist with the inspection. On the first day of the inspection we made a site visit to the offices of the service. On the second day we conducted a telephone survey of people who use the service and relatives of those people who had given permission.
The inspection was carried out by two inspectors 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. The expert who assisted us with this inspection was experienced in caring for older people and had personal knowledge of using services.
Before the inspection we reviewed the information we held about the service which included notifications they had sent us. A notification is information about important events which the service is required to tell us about by law. We looked at previous inspection reports and contacted three community professionals for feedback. We did not receive any feedback from professionals. We also contacted the local authority safeguarding team who confirmed there were no safeguarding concerns.
We reviewed the Provider Information Return (PIR).This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with seven people who use the service and four relatives. We spoke with four members of staff including the manager and three care staff. We received written feedback from a further two staff following the inspection. We looked at records relating to the management of the service including six people’s care plans and associated records. We reviewed six staff files including the recruitment records. We looked at staff training records, the compliments/complaints log and accident/incident records.
Updated
3 February 2018
This was a comprehensive inspection which took place on 11and 12 December 2017 and was announced. We gave the manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office to assist us.
Lifecarers (Bracknell, Crowthorne and Sandhurst) Ltd. is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger disabled adults, people living with dementia and people with disabilities. The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using Lifecarers (Bracknell, Crowthorne and Sandhurst) Ltd. receives the regulated activity. Where they do we also take into account any wider social care provided.
The service did not have a registered manager as required, however, a manager had been appointed and had begun the process of applying to be registered. A registered manager is a person who has registered with the CQC 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. The manager was present and assisted us during the inspection.
At the last inspection the service was rated Good. At this inspection we found the service remained Good overall but they required improvement in Safe.
Risks associated with people’s health and the care they received were assessed. However, guidance for staff on how to minimise the risks was not always sufficiently detailed. This was mitigated by the good communication and information sharing between staff. Accidents and incidents were recorded but it was not clear what investigation had taken place and how lessons learnt were shared from these. Following the inspection the manager sent us evidence of how they were addressing these issues.
People told us they felt safe with the care staff, while relatives confirmed they felt confident their family members were cared for safely. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They reported concerns promptly when necessary. People received their medicines safely when they required them.
People continued to receive effective care from staff who were trained and had the necessary skills to fulfil their role. Staff felt supported by one to one meetings supervision meetings, annual appraisals and staff meetings. These all provided them with time to seek advice, discuss and review their work. They had opportunities to develop their skills and knowledge as well as gain relevant qualifications. The service worked well with other teams of professionals to provide effective care for people.
When required people were supported with nutrition and hydration. People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.
People reported staff were kind and patient. People’s privacy and dignity were protected, they told us staff treated them with respect. People and when appropriate relatives were involved in making decisions about their care.
The service was responsive to people’s individual needs. Staff knew people well and individual care plans were person-centred. They focused on the diverse needs and preferences of each person along with their desired outcomes. People’s views were sought and they knew how to raise concerns or make a complaint if necessary. We have made a recommendation that the provider review current guidance and best practice about the Accessible Information Standard.
The service was well-led. There was an open, person centred culture with a strong emphasis on providing excellent care which was led by example. The management team listened to feedback and worked toward making improvements in the service. Governance systems helped monitor the quality of the service.
Further information is in the detailed findings below.