Sylvan Home Care Services - Bromborough Branch

Updated 9 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection started on 21 November 2018. This is when we visited the registered office to speak with the registered manager and to review documentation. We made phone calls to people who used the service and staff on 22 November 2018. We also requested some additional information which was sent by email after the initial inspection visit.

The inspection was announced. The provider was given 48 hours’ notice as the service provides domiciliary care, and we wanted to be sure staff and people who used the service gave consent and would be available to speak with us.

The inspection was conducted by an adult social care inspector.

Before our inspection visit, we reviewed the information we held about Sylvan Homecare. This included looking at the notifications we had received from the provider about any incidents that may have impacted on the health, safety and welfare of people who used the service. We had received some concerns in relation to staff training and staff rotas being difficult for staff to complete. We checked both of these during our inspection. We also looked at the Provider Information Return (PIR) we received from the provider prior to our inspection. This form asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We had not requested a PIR. Additionally, we approached local stakeholders for feedback about the service. We received two responses. We used this information to help us plan our inspection.

We spoke to five people who used the service and one relative. We spoke with four staff, the registered manager, deputy manager and quality officer. We looked at the care plans belonging to four people and other related records. We checked the recruitment files for four staff. We also looked at other documentation associated with the running of the service.

Updated 9 January 2019

This inspection took place on 21 and 22 November 2018 and was announced.

The inspection was partly prompted due to some concerns we had received concerning staff training and missed calls. We discussed these concerns with the registered manager during our inspection who was aware of and had resolved these issues.

At the time of our inspection the service was providing small packages of care to 40 people.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community as well as specialist housing. It provides a service to older adults and younger disabled adults. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks relating to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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.

Risks assessments were in place and were reviewed regularly. Risk assessments were in place and contained information with regards to the management and reduction of risk. Some information was not always recorded clearly. We discussed this at the time with the registered manager.

Staff were recruited safely and checks were made on their character and suitability to work with vulnerable adults. Staff were only allowed to work once these checks came back as satisfactory.

Medication was stored in people's own home and administered safely. Where staff were responsible for administering people's medication this was done by trained staff who had their competency assessed by the registered manager. There had been some concerns around the administration of medications, however we saw that lessons had been learnt from these and practices had improved.

Staff were provided with Personal Protective Equipment (PPE) such as gloves and aprons in accordance with the service's infection control procedure.

Staff were aware of safeguarding procedures and were able to describe the action they would take to ensure people were kept safe from harm. This included raising alerts to the registered manager, local authority safeguarding teams, the police, or whistleblowing.

There was some confusing information around the application of the Mental Capacity Act 2005 and best interests. We saw that despite the registered manager and the staff having an understanding of this legislation, the care plans we viewed differed in their documentation of MCA and best interests. We have made a recommendation about this.

People were supported by staff with eating and drinking and staff were aware of people’s dietary preferences.

Staff supported people to contact other healthcare professionals such as GP’s and District Nurses if they felt unwell.

Staff undertook training in accordance with the registered providers training policy. Staff told us they enjoyed the training. Training was a mixture of e-learning and practical training sessions. Staff spoken with confirmed they had regular supervision and an annual appraisal.

People we spoke with were complimentary about the caring nature of the staff and we received positive comments about the registered manager. We did not observe care being delivered, however, people told us staff were kind and caring in their approach. One person discussed some concerns they had at the beginning of the care package, however did say the office staff had responded promptly and these were now addressed.

People told us that they were always kept informed and involved in their care.

Care plans contained information about people, what their preferences were and how they liked their care to be conducted. Information in care plans was regularly reviewed and updated in line with people’s changing needs.

Complaints were investigated in line with the complaints procedure and responded to appropriately.

Audits took place which checked service provision and action plans were implemented to improve practice. A new auditing tool had recently been introduced to check medications.

There were polices in place for staff to adhere to, however we raised at the time of our inspection that some of these policies would benefit from being further reviewed due to some incorrect information. This was done before we left the site.

Feedback was gathered from people using the service and people told us they felt that the registered manager had responded to their comments.