16 July 2018
During a routine inspection
Park House Home Care Services is a domiciliary care agency. It provides personal care to 31 people living in their own houses and flats in the community. It provides a service to older people and younger adults some of whom have a physical disability, sensory impairment or dementia.
Not everyone using Park House Home Care Services receives a regulated activity; 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.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 supported by staff who had received safeguarding training and knew how to keep people safe from harm or abuse. Risks to people were assessed and managed. The service had a recruitment and selection process that helped reduce the risk of unsuitable staff supporting people. People received their medicines on time and as prescribed. Staff understood the importance of infection prevention and control and wore protective equipment appropriately when supporting people. Learning from accidents and incidents was analysed and shared with the team to reduce the chance of them happening again.
People’s needs were assessed with their involvement and, where appropriate, those important to them. People were consulted with about changes to their care plans and reviews. People were supported by staff who had an induction and an ongoing programme of training. Training covered mandatory topics and areas specific to people’s needs such as diabetes and end of life care. Staff received regular supervision and checks of their competency. People were encouraged and supported to eat and drink sufficiently. The service understood the important of keeping people healthy by timely contact with health professionals. Where people’s health needs changed staff supported people to contact health professionals such as GPs and district nurses.
People were supported by staff who understood the importance of offering choice and support in line with what they needed and wanted. 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. Staff asked for people’s consent before offering to support them. Where people lacked capacity to make particular decisions they were supported by staff who were trained and worked in line with the principles of the Mental Capacity Act 2005.
The service does need to ensure that only people with the correct legal authority are asked to sign to give consent on behalf of people who are assessed as lacking capacity to make certain decisions. This should include determining whether people’s lasting power of attorneys can sign to give consent for decisions about a person’s finances and/or health and welfare.
Staff consistently demonstrated a kind and caring approach towards people. People’s privacy and dignity was supported at all times. People were supported by staff who were respectful and knew them well. People were encouraged to maintain their independence. One person said, “[The carers] are all very good. They do what I need and I do the rest.”
People were supported in line with their assessed needs. Where people’s needs changed their package of care was amended to reflect this. People felt the service listened to them and made changes to support their requests. People told us this and we also heard telephone conversations where this happened. People and their relatives knew how to complain and told us they had confidence that any issues would be investigated and resolved to their satisfaction. We saw that complaints had been resolved in line with the service’s policy. The service met the requirements of the Accessible Information Standard (AIS). This is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need. We saw this detailed in people’s care plans and staff meeting people’s specific communication needs during our visits to people in their homes.
There was an open and supportive culture at the service. Staff were encouraged to contribute their views and ideas. The staff got on well and told us they enjoyed working for the service. They told us they felt supported and listened to. Staff achievements were recognised and shared with them. Staff were given opportunities and support to achieve qualifications in health and social care to help improve their practice and further their careers. Regular communication via team meetings and weekly staff memos had helped develop and maintain a cohesive team focused on providing a good service and improving. The service sought feedback from people, staff, relatives and health professionals annually. This had been positive. A range of audits were undertaken to help maintain the quality of the service and identify where improvements could be made.
The service had established and maintained good working relationships with other agencies such as district nurses, surgeries and social work teams. This had supported people to remain well in their homes for longer and to support people’s successful return home from hospital.