Background to this inspection
Updated
30 September 2016
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.
The office visit took place on 7 September 2016 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be available to meet with us. The inspection was conducted by 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.
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 reviewed the information we held about the service. We looked at information received from relatives, from the local authority commissioners and in the statutory notifications we had received during the previous 12 months. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.
Before the office visit, we sent surveys to 50 people who used the service and 50 relatives and friends of people who used the service, to obtain their views of the care and support. Surveys were returned from 17 people and two relatives. We also spoke with eight people who used the service and three relatives by telephone. During our inspection visit, we spoke with the registered manager, the compliance manager, a compliance officer and an office administrator. After our visit, we spoke with seven care staff by telephone.
We reviewed seven people’s care plans and daily records, to see how their care and support was planned and delivered. We checked whether staff were recruited safely and trained to deliver care and support appropriate to each person’s needs. We reviewed records of the checks the management team made to assure themselves people received a quality service.
Updated
30 September 2016
We inspected this service on 7 September 2016. The inspection visit was announced.
The service delivers personal care to people in their own homes. At the time of our inspection, 162 people were receiving the service.
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. On the day of the inspection visit, the provider’s compliance manager supported the registered manager to explain how the service operated and was managed.
People told us they felt safe with the staff that came to their home. Staff were trained in safeguarding and understood the signs of abuse and their responsibilities to keep people safe. The provider’s policies for keeping people safe included pre-employment checks, to make sure staff were suitable to deliver care in people’s own homes.
Risks to people’s health and wellbeing were identified at the initial assessment of care and their care plans included the actions staff should take to minimise the risks. Staff understood people’s needs and abilities because they read their care plans and shadowed experienced staff, so they could get to know people well before working with them independently.
The manager assessed risks in each person’s home, so staff knew the actions they should take to minimise the risks. All staff were trained in medicines management, to ensure they knew how to support people to take their medicines and to keep accurate records.
Staff received the training and support they needed to meet people’s needs effectively. Staff had regular opportunities to reflect on their practice, to attend training in subjects that interested them and to consider their personal development.
The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People made their own decisions about their care and support. Staff understood they could only care for and support people who consented to receive care from them.
People were supported to eat meals of their choice and staff understood the importance of people having sufficient to drink. Staff referred people to healthcare professionals for advice and support when their health needs changed.
Staff had regular care calls so they got to know people well. People told us staff were kind and respected their privacy, dignity and independence. Care staff were thoughtful and recognised and respected people’s cultural values and preferences.
People were confident any complaints would be listened to and action taken to resolve them. When people raised issues, the registered manager resolved them immediately, through face-to-face meetings with people.
The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits by a supervisor and regular questionnaires.
The manager checked people received the care they needed by monitoring the time staff arrived for scheduled calls, reviewing care plans and daily records, and through feedback from supervisors.
.