Background to this inspection
Updated
23 November 2017
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.
The provider was given 48 hours' notice because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available.
The provider completed a Provider Information Return (PIR) in advance of the inspection. 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.
Before the inspection, we checked notifications made to us by the provider, safeguarding alerts raised about people using the service, and information we held on our database about the service.
The inspection was carried out by two adult social care inspectors and an Expert by Experience, which 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 their views of the service.
There were 13 people using the service for personal care support on the day of our inspection visit. During the inspection, we received feedback about the service from three people using it and five people’s relatives. We also spoke with eight care staff.
During our visit to the office premises we spoke with the registered manager and office manager. We looked at the care files of four people using the service, the personnel files of three staff members and various other records relating to the care delivery and management of the service such as the staffing roster, training records and stakeholder surveys. The registered manager also sent us further information on request following the inspection visit, including copies of policies and visit schedules.
Updated
23 November 2017
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 people of any age, including those with dementia, mental health needs, or physical disabilities. At the time of this announced inspection, they were providing personal care and support to 13 people living in their own homes. This was the first inspection of this service at this location.
The service had a registered manager. 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 and their relatives provided good overall feedback about the service, particularly about the caring nature of their regular staff. However, some told us timekeeping was an issue as staff were not always arriving when they were expected. We found visit scheduling arrangements were not always robust enough to ensure people consistently received expected care visits on time. However, no-one reported visits were being missed, and it was clear that the service provided people with the same staff members where possible.
The service supported people well with ongoing healthcare matters. There was effective collaborative working with healthcare professionals, in part due to the registered manager’s previous experience of community nursing. People were supported to have comfortable and dignified end-of-life care where this was needed.
The service assessed and managed risks relating to care delivery in people’s homes. This included for safe support with medicines, hoisting, and nutrition where part of agreed the care package.
People were supported to express their views and make decisions about their care and support. Consent to care was sought in line with legislative principles. Care plans were in place to formalise the process.
People received care and support from staff who responded to their individual needs and preferences, and who had the knowledge and skills needed for their care roles. The service listened to and learnt from people’s concerns and complaints, and responded well when further care support was needed as the registered manager knew people well and provided hands-on support at short notice where needed.
The service had systems to help protect people from abuse and ensure safe staff recruitment practices occurred.
The provider asked people’s views on how the service operated so as to improve, and promoted a positive working culture for staff. Audits of care records had been embedded, to help ensure good quality care was occurring. However, there were no documented arrangements for oversight of quality checks of staff and quality visits to people using the service, to ensure these covered everyone. In conjunction with the staff visit scheduling concerns, this demonstrated the service was not consistently well-led.