The inspection was carried out by one inspector who gathered evidence to help answer our five questions; Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.
Is the service safe?
The service was not safe.
We looked at completed 'service user risk assessment' forms. These detailed people's personal details such as date of birth and next of kin, the health professional involved in their care and the identified risk. One person had been assessed at high risk of falling and although this was evident on their initial service user risk assessment, it was not evident on some of the updated risk assessments. We noted the person had experienced further falls. This meant the service failed to ensure identified risks were evident when reviews of risk were updated.
People told us they felt safe and knew what to do if they had concerns. We heard comments such as, 'I went away for a small break and didn't worry about whether X was going to be looked after. If I had any concerns I would speak with the manager' and 'If I had concerns, I would report it immediately to the office.' This showed people who used the service were aware of how to raise concerns of abuse.
Is the service effective?
The service was not effective.
We saw one person had been assessed as having capacity to make specific decisions when they joined the service. However after a period of time a situation arose where a specific decision had to be made regarding the person. We saw no evidence of the person being involved in the decision and no further mental capacity assessment to show the person lacked capacity to make the decision. This meant people could not be confident their human rights would be respected and taken into account.
One person told us, 'The manager visited and carried out an assessment. It was a very good interview; all the questions they asked were relevant.' This helped the service to develop a plan of care based upon the care needs identified.
Staff received appropriate professional development. Staff spoke positively about their induction experience. One staff commented, 'Some of the courses I attended were Mental Capacity Act 2005 (MCA), safeguarding adults, food and hygiene and fire safety. It was very helpful as it showed me how to look after my clients and increased my knowledge.' This showed staff acquired skills and qualifications that were relevant to the work they undertook.
Is it caring?
The service is caring.
People spoke positively about the care they received. We heard various comments such as, 'The care is not rushed' and 'I find them (staff) absolutely excellent', and 'I definitely feel safe with the care delivered. They are always very caring' and 'They are very good for time keeping' and 'The carers I have always makes me laugh.' This showed people were supported by caring staff.
Is it responsive?
The service is responsive.
One relative commented, 'I do have a look at the care plan and it is reflective of X's needs' and another person told us, 'I have read my care plan and it accurately reflects the care they have given. When carrying out personal care staff knows exactly what part of my body I like to wash.' This meant the delivery of care was centred on people's individual needs and reflected their preferences.
Is it well-led?
The service is well-led.
We saw unannounced spot checks were undertaken to ensure staff carried out their roles in line with the service's policies and procedures. The manager told us spot checks were carried out regularly when a new staff member joined the service or if concerns were raised about staff. Spot check records reviewed showed areas of work discussed and actions taken when concerns were identified. This meant the service had systems in place to monitor, assess and review staff competency.