Background to this inspection
Updated
10 February 2016
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 was carried out on 22 and 23 December 2015 and was announced. The provider was given 48 hours notice because the location provides a domiciliary care service. The provider ensured that people were available to speak with us on the day of the inspection. The inspection was carried out by two inspectors.
Before the inspection, we reviewed all the information we held about the service including the previous inspection reports and notifications received by the Care Quality commission. A notification is information about important events which the provider is required to tell us about by law. We used this information to help us decide what areas to focus on during our inspection. We did not request a Provider Information Return (PIR) from this provider prior to the inspection. This is a form which asks the provider to give some key information about the service, what the service does well, and what improvements they plan to make.
During our inspection we spoke with two relatives and five people. We also spoke with the registered manager and three support staff. We reviewed records relating to the management of the service, such as audits, and reviewed two staff records. We also reviewed records relating to six people’s care and support such as their support plans and risk assessments. We observed some people being supported in the tasks of daily living in their own home.
We last inspected the service in December 2013 and found no concerns.
Updated
10 February 2016
This inspection was carried out on 22 and 23 December 2015 and was announced.
Room 29/30 provides personal care to adults with a learning disability, physical disabilities, mental health needs or sensory impairment. At the time of our inspection twelve people were receiving personal care.
Room 29/30 has 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.
Staff had received safeguarding training and were able to describe sources and signs of abuse and potential harm. The registered manager told us that the safeguarding policy had just been updated and was available to staff online.
Each person had a health and safety risk assessment which considered which aspects of a person’s care could present risks to their health, safety and wellbeing. Staff told us there was specific guidance to mitigate risks, such as checking the water temperature before people stepped into the shower. One staff member told us that if they identified any further risks they would notify the office immediately who would update the risk assessments. Risk assessments were regularly reviewed and updated.
Incidents and accidents were recorded appropriately and investigated where necessary. There had only been one accident in the last year. Appropriate actions had been taken to prevent the accident from re-occurring and the service had worked with other agencies to ensure appropriate measures had been put in place. This meant the provider took action to reduce the risk of further incidents and accidents.
There were enough staff to meet the needs of people using the service. The rostering system identified the calls and then matched these with staff available to cover. People told us that they had never had a missed call from staff. Bank staff were available to cover emergencies such as staff sickness.
Recruitment procedures were safe. There was a recruitment policy in place, which was followed by the registered manager. Disclosure and Barring (DBS) checks were carried out before anyone could be recruited. These checks identify if prospective staff had a criminal record or were barred from working with people at risk. Potential staff had to provide two references and a full employment history, to ensure they were suitable to work within the service.
The service was not responsible for administering medicines to people. People were reminded to take their medicine or to reorder their medicines from their GP where necessary. Staff had received medication awareness training, as a safeguard, in case there were any incidents involving people’s medicine which they needed to respond to.
Staff had received appropriate training to deliver the care and support for people using the service. Records showed that training covered all essential areas such as emergency first aid, fire prevention and awareness, infection control and manual handling. Training was delivered via e-learning and workshops and staff could request additional training in areas where they had a specific interest or need.
People were asked for consent before care and support was provided. Everyone said they were asked for their consent. Everyone using the service had the capacity to give valid consent for the care and support they received.
Food and nutrition was not included as part of the service provided to people. People were supported to go shopping to purchase their own food.
Health professionals were appropriately involved in people’s care. People were supported to attend medical appointments when they requested it.
People told us that staff were kind and caring. Staff told us they got to know people by talking to them and listening to them. They were able to describe people’s individual likes and dislikes such as the types of toiletries they preferred or their hobbies. We observed mutual positive caring relationships between staff and people. Staff knew how to treat people with dignity and respect.
People were supported to be as independent as possible. The service was set up to maintain people’s independence in their own homes. Staff told us they encouraged people to do as much as possible for themselves in terms of washing, shopping, cleaning and organising their medicine.
People were involved in writing their support plans. Person centred assessments were carried out when a person started to receive care and support. Where they were able to, people had written these themselves. They included information about people's health needs, sensory ability, mental health and a skills checklist identifying strengths and areas where support was required. Specific guidelines were written about how people liked to receive their support.
Support plans were kept up to date with six monthly reviews. People’s support plans which were held in the office demonstrated that these reviews had taken place, however people’s support plans in their own homes were not quite as up to date. Staff told us they were in the process of ensuring that support plans in people’s homes reflected the updates described in the office copy. People were able to communicate their needs verbally.
Feedback was encouraged from people and staff. A ‘Service user working together group’ had been implemented, which met monthly. This included people using the service and staff who had volunteered. The group were involved in developing policies and practices for the provider which could be implemented across all the provider’s services.
Regular staff meetings were held, which gave staff the opportunity to raise their views. They could also discuss matters individually with managers during supervision meetings. All the staff we spoke with said they could talk to the registered or deputy manager any time if they had any concerns or worries. An annual survey was carried out and people were asked their views about the service they received.
There was an open and transparent culture within the service. Staff told us that management were open always kept them updated. Key values, such as person centred care, underpinned the service and were demonstrated through support and care provided to people. Staff were valued by the provider and protected from risk, such as lone working.
The registered manager was well known and respected amongst staff and people. Everyone said they would speak with her if they had a concern. The registered manager made the required notifications to the CQC. A notification is important information about the provider which the service has a legal duty to notify CQC about.
An effective system of quality control was in place to ensure the quality of the service delivered to people. A continuous improvement plan had been written in September 2015. The plan focussed on making the support, the team and the environment even better.