Background to this inspection
Updated
29 November 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 inspection took place on 4 October 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 who had experience with domiciliary care services for people with learning disabilities and mental health problems.
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, social workers and advocates 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. Advocates offer help to people who may not have anyone else who can help them make decisions.
Before the inspection, we sent surveys to people who used the service and relatives and friends of people who used the service, to obtain their views of the care and support. Surveys were returned from three people and one relative. We also spoke with three people who used the service and three relatives by telephone. During our inspection visit, we spoke with the registered manager, a care coordinator, the head of care, an office administrator and the HR business partner. During our inspection we spoke with three members of care staff. We also gained feedback from two social workers and three advocates.
We reviewed three 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
29 November 2016
We inspected this service on 4 October 2016. The inspection visit was announced.
The service delivers personal care to people in their own homes. At the time of our inspection, 12 people were receiving the service. The service predominantly supports people with a learning disability or with mental health support needs.
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 head of care 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 had introduced a safeguarding spot check of the service so staff were kept abreast of the safeguarding policy and procedure. Staff were recruited safely.
Risks of harm to people were identified at the initial assessment of care and their care plans included the actions staff would take to minimise the risks. Staff understood people's needs and abilities because they had the opportunity to get to know people well through shadowing experienced staff during induction before working with them independently.
The manager identified potential risks in each person's home, so staff knew the actions they should take to minimise the risks. Staff were trained in medicines management, to ensure they knew how to support people to take their medicines safely 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.
People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. Staff referred people to healthcare professionals for advice and support when their health needs changed.
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 and relatives said that the service was responsive to their needs however concerns were raised to us about the use of agency staff, the consistency of care and the lack of proactive support for people when keyworkers were not on duty. A keyworker is a carer who is the main contact and organiser of a person’s care
People were confident any complaints would be listened to and action taken to resolve them. When people raised issues, they would be investigated and resolved.
The service was well led however there was some confusion for care professionals about who was managing the service. A social worker also said the service needed to improve their communication with them.
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 care coordinators.