Archived: Cura Domi - Care at Home Ltd

This inspection took place on 10 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be available to assist us during the inspection. This was a comprehensive inspection.

There was no registered manager at the service. The current manager was in the process of going through our registration process. 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.

Records did not demonstrate full compliance with the Mental Capacity Act 2005. Where people could not consent to care, relatives had signed their consent forms. There were no mental capacity assessments or best interests decisions documented. We recommended that records be updated with this information.

Staff understood their responsibilities under the Mental Capacity Act and demonstrated a good understanding of how to offer people choice.

The provider followed safe recruitment processes and there were sufficient numbers of staff to meet people’s needs.

Risks to people were assessed and reviewed regularly to ensure people's individual needs were being met safely. People’s medicines were administered by trained staff and records were up to date to ensure medicines were administered safely.

People and relatives told us they felt their family members were safe and were confident in the staff that supported them. A contingency plan was in place to ensure that people’s care could be provided safely in the event of staff being late or unavailable.

People told us that staff were competent and skilled in carrying out their role. The provider had effective arrangements in place to train, supervise and provide induction to staff. Staff told us they felt supported by the provider and could call for assistance at any time.

Assessments were completed prior to people receiving a service to ensure their needs could be met. Detailed care plans were in place and records were updated following reviews or changes in people’s needs. People were supported to access support from healthcare professionals where required.

People told us they were confident to raise any issues about their care. There was a complaints policy in place and there was evidence that complaints had been recorded, investigated and responded to.

The service had systems in place to monitor and improve the quality of the service provided through seeking people’s feedback and carrying out audits. People told us they had seen improvements in their care and responsiveness of the manager. The manager had a vision for the future of the service and was taking steps to overcome identified challenges.

Discussions with staff, relatives and people who use the service showed us that people were able to make their own choices about what they had to eat and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Family members that we spoke with felt they their relatives were well cared for and safe in their homes. People that we spoke with felt safe and secure in their homes.

Staff that we spoke with felt very valued and supported and said that supervision and training provided was great and that it gave them time to reflect upon their working practice. Supervision records that we looked at confirmed this. We saw staff training records this showed us that staff were qualified and competent to look after people.

We spoke with one person who used this service and with the representatives of two other people. They told us that the care was good and that people were consulted and listened to with regards to how their care was planned and delivered.

We saw that the provider worked with other care and health providers to ensure that the care people received was delivered effectively and was responsive to their changing needs. People were given the correct support to manage their medicines and the provider had good systems in place where it needed to manage medicines on people's behalf.

The provider had effective recruitment and induction procedures in place to ensure that staff were fit for their role.

The provider ensured that people's personal information was stored securely but was accessible when needed. The provider ensured that obsolete records had not been retained longer than they were needed.