The inspection took place on 1 May 2018 and was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.This was the first inspection since the service registered in April 2017. The service had moved to the current location in March 2018.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. There was one person using the service since February 2018 and one care worker working for the service. The service was also registered to provide supported living support but at the time of the inspection this was not being offered to people in the community.
There was a manager in post who had applied to be the registered manager and their interview for this position was three days after the inspection. 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.
Systems and procedures had not been put in place to ensure safe management of medicines to reflect current legislation and national guidance.
There were some systems in place to monitor and assess the quality of the service. However, these needed to expand to cover more aspects of the service and identify what was working well and where improvements needed to be made.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.
Care plans were in place which described their support needs. However, we recommended for the provider to seek national guidance on writing person centred care plans that recorded specific information relating to that person.
The provider had systems in place to assess people’s needs before the person started to receive a service. Risks were assessed so that care workers knew how to safely support the person. Care workers completed a record of the support they provided during each visit. These records needed to contain more detailed information to ensure there was a clear record of how the person was at each visit.
A relative told us they were happy with the care the person using the service received. They told us that care workers arrived on time and stayed the agreed length of time. They explained that care workers did everything they asked and offered the person choices.
People were supported to eat and drink sufficient amounts. Their health needs were identified and recorded in their care files and care workers supported them with these if this was required.
There were enough care workers recruited to care for and support people. The provider's recruitment procedures included making checks on the suitability of the staff. The provider needed to make sure robust checks and processes were in place to ensure they were confident in employing the new care worker.
The provider had arrangements in place to support the care worker through one to one meetings, training and spot checks carried out on their work to make sure they were doing everything right. The care worker told us they could contact the manager or provider and ask for help whenever they needed.
The provider had arrangements to help protect people from the risk of the spread of infection as they ensured they had an adequate supply of protective equipment for the care worker, such as gloves and aprons, when providing care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider was aware of their responsibilities and had acted in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
The provider and manager regularly contacted people using the service and their relative to ask for their feedback.
The provider had a complaints process in place and the relative we spoke with knew what to do if they wished to raise any concerns.