Background to this inspection
Updated
8 June 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 was 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 17 April 2018. The provider was given 48-hours’ notice of our visit because we wanted to ensure the registered manager was available to support the inspection. One inspector carried out the inspection.
Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the registered person is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection. We also reviewed the Provider Information Return (PIR) submitted by the provider on 8 February 2018. The PIR 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 our inspection we visited the agency’s premises and spoke with the registered manager. We checked care records for four people, including their assessments, care plans and risk assessments. We checked four staff recruitment files and other records relating to the management of the service, including staff supervision and training, the complaints log and quality monitoring checks.
After the inspection we spoke with 10 people who used the service and four relatives by telephone to hear their views about the care and support the agency provided. We received feedback from seven care staff about the training and support they received to do their jobs.
This was the first inspection of the service since its registration with CQC under this provider. The service had previously been registered with CQC under a different provider.
Updated
8 June 2018
The inspection took place on 17 April 2018 and was announced.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults, including people living with dementia, and younger adults who may have needs related to a physical or learning disability. There were 99 people using the service at the time the provider returned their provider information return (PIR) on 8 February 2018, 12 of whom were receiving live-in care.
Not everyone using the service received the regulated activity personal care. 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 at the time of our inspection. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
Staff provided people’s care in a safe way. They understood any risks involved in people’s care and managed these well. People felt safe when staff provided their care and said staff used any equipment involved in their care safely.
There were enough staff employed to meet the agency’s care commitments. The provider carried out checks to ensure they employed only suitable staff. Staff attended safeguarding training and understood their responsibilities in terms of recognising and reporting abuse.
The provider had made plans to ensure people’s care would not be interrupted in an emergency. If an incident or accident occurred, this was recorded and checked to identify what action could be taken to prevent a recurrence. Action had been taken to improve when people had experienced poor care.
Staff maintained appropriate standards of infection control. Where people received support with their medicines, this was managed safely.
People’s needs were assessed before they used the service to ensure the agency could meet their needs. People were encouraged to contribute to their assessment to ensure they agency understood their needs and preferences.
Staff had access to the training and support they needed to do their jobs. All staff attended an induction which included all elements of mandatory training and shadowing colleagues to understand how people preferred their care to be provided. Staff had access to regular refresher training and training relevant to the needs of the people they cared for. Staff had opportunities to speak with their managers about their performance and training and development needs.
People’s care was provided in accordance with the Mental Capacity Act 2005. Staff understood the importance of consent and respected people’s choices about their care. If people lacked the capacity to make decisions, relevant people had been consulted to ensure any decisions were made in the person’s best interests.
The agency worked effectively with other professionals when people moved between services, working closely with local hospitals regarding planned discharges to ensure people’s transition from hospital to home was well managed.
Staff monitored people’s healthcare needs and responded appropriately if their health deteriorated. Staff accompanied some people to healthcare appointments and communicated with healthcare professionals where people wished them to do so.
People’s nutritional needs were assessed when they began to use the service. A care plan was developed to meet any identified dietary needs and specialist professional input obtained where necessary.
Staff were kind and caring. People received their care from regular staff who knew them well. People told us they had developed positive relationships with their care workers and enjoyed their company. Relatives said staff treated their family members with respect and maintained their dignity when providing care. Staff supported people to maintain their independence wherever possible.
People received a service that was responsive to their individual needs. Each person had an individual care plan, to which they were encouraged to contribute. People were supported to pursue their interests and to take part in activities they enjoyed.
The agency responded effectively if people’s needs changed and worked closely with hospitals regarding the care of people towards the end of their lives. People with life-limiting conditions who wished to return home from hospital were supported to do this with the agency’s support. The agency worked well with other professionals to ensure people received the package of care they needed.
People knew how to complain if necessary and were confident any concerns they raised would be taken seriously. The agency’s complaints log demonstrated that complaints were investigated and responded to appropriately.
The agency was effectively managed. The registered manager provided good leadership and there was a clear distribution of roles in the office team. People and their relatives could contact the agency’s office when they needed to. There were systems to monitor the quality of the service which included seeking the views of people who received care and their relatives. The agency had established effective working relationships with other professionals involved in people’s care, including GPs, district nurses and occupational therapists.