Background to this inspection
Updated
20 April 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 inspection took place on 7 March 2018 and was announced. As the location provides a domiciliary care service to people in their own homes, the provider was given 48 hours' notice. We needed to be sure that representatives of staff and management would be at the office and would be able to assist us to arrange home visits.
The inspection site visit activity started on 7 March 2018 and ended on 12 March 2018. It included visiting the office, speaking with staff and speaking with people who used the service and their relatives. We visited the office location on 7 March to see the registered manager and to review care records and policies and procedures. We spoke with staff on 9 and 12 March 2018.
The inspection team consisted of one inspector 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. Their involvement was limited to phoning people using the service and their relatives to ask them for their views on the service.
Before the inspection, the provider completed a 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. We used this information to assist in our planning of the inspection. In addition we looked at notifications which the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We also spoke with local commissioners to obtain their views about the service.
During the inspection we spoke with four people who used the service and one person’s relative. We also spoke with three members of staff and the registered manager. We looked at a range of records during the inspection. These included four care records and four staff files. We also looked at information relating to the management of the service, including quality assurance audits, policies, risk assessments, meeting minutes and staff training records.
Updated
20 April 2018
This announced inspection took place on 7 March 2018.
This service is a domiciliary care agency. It provides 24-hour care to people living in their own houses and flats. The agency provides a service to older adults and younger disabled adults. Not everyone using this service receives regulated activity; the CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
There was 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.
People were safe as staff had been suitably trained and knew how to support people in a way that protected them from danger, harm and abuse. Staff knew how to accommodate support delivered to people so that the risks of harm associated with people’s care were minimised.
People were supported to take their medicines safely and in accordance with the prescribed instructions. There were infection control processes and procedures in place to reduce the risks of cross infection.
Most aspects of safe recruitment practices, such as police identity and character checks, were in place. However, the provider had failed to gather full employment history of some of their prospective staff members. The identified gaps in the employment history had not been fully examined and explained. However, this had no impact on the quality of care provided to people.
People received care from staff that had the skills and knowledge to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to those they supported and any additional training needed to meet people's requirements was provided.
The service was working within the principles of the Mental Capacity Act 2005. People's consent was sought before any care was provided.
People had access to healthcare services when needed and staff responded to any changes in people’s needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.
People had positive relationships with the staff members who supported them. Staff were aware of people's likes and dislikes which enabled them to provide people with highly individualised care.
People told us that staff were respectful and caring. Care records guided staff in how people's privacy, dignity and independence should be promoted and respected. People were involved in making decisions about their care and support. People's views were valued and people were encouraged to voice their opinions on how their care was planned for and delivered. People told us they felt listened to.
People were given information in a way they could understand it. There was a complaints procedure in place and people knew how to raise a complaint about the service they were provided with.
There were policies and procedures in place in relation to end of life care. Whilst the service was not currently supporting anyone at the end of their life, staff had received relevant training and were knowledgeable and confident in this area.
Staff received support and guidance from the management team whom they found approachable. People and staff felt able to express their views and felt their opinions mattered.
There were effective quality assurance measures in place used to identify trends and drive improvements.
The service worked in co-operation with other organisations such as healthcare services to deliver effective care and support.