Derby City Council Home First

Updated 2 March 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 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.

This comprehensive inspection took place on 5 February 2019 and was announced. We gave the provider 48 hours' notice of our visit to ensure they were available to talk with us when we visited. The inspection was undertaken by one inspector.

Prior to our inspection visit, we reviewed the information we held about the service including any statutory notifications. A statutory notification is information about important events which the provider is required to send us by law.

The provider had completed a Provider Information Return (PIR). This is information that we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our visit to the office we spoke with the registered manager, with the head of Home First, a multi disciplinary team of eight staff, two office based staff as well as having discussions with another four staff later in the day.

We reviewed four care plans, risk assessments, daily care and medicines administration records. This meant that we saw how people’s care and support was assessed, planned and delivered. We also reviewed information relating to staff recruitment, training and supervision.

Following our inspection visit we telephoned five people, and relatives of people, who received care and support from the service. We also reviewed documents and information provided to us after the inspection.

Updated 2 March 2019

This inspection took place on 5 February 2019. The inspection was announced. We gave the provider 48 hours' notice of our inspection to ensure we could meet with them.

Derby City Council Home First is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides short term support and rehabilitation to people who are recovering from injury or illness. The service therefore helps prevent long hospital admissions or short stays in a care facility until the person is independent following ill health. The service enables people to receive all necessary support and care in their home until they are independent.

Not everyone using the service receives 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.

At our last inspection we rated the service as overall 'Good'. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. At the time of our inspection, 16 people were in receipt of personal care and support with Home First. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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 relatives told us staff worked in a safe and reliable way. The provider followed appropriate procedures to ensure people were safeguarded against harm and abuse. Staff understood and were trained to know about different types, and signs, of abuse. They also knew the necessary actions they needed to take if they had any concerns.

There were suitable and sufficient staff to meet people’s needs safely. People’s medicines were managed and handled in a safe manner. There were systems in place to learn lessons when things went wrong.

People’s needs were assessed and fully reviewed before they received any personal care and support. People told us that their healthcare and nutritional needs were met by staff who knew them well.

Staff had regular training, supervision and appraisals. They confirmed that that were supported to deliver an efficient and personalised service. People were supported to access healthcare services where this was required.

People were supported to have maximum choice and control of their lives and daily routines. This was undertaken in the least restrictive way possible, to enable independence. Policies, procedures and systems in place at the service supported these practices.

People told us they found staff caring, kind and considerate. They felt that staff listened to them and fully included them in the care planning process. People’s culture religious and cultural needs were recognised and taken into consideration.

People confirmed that their care and support was responsive to their needs. Staff were knowledgeable about people’s preferences and their routines, ensuring they received personalised support. Care and support plans were regularly reviewed, even during very short periods of support, to make certain routines were meeting people’s needs.

People and relatives knew how to raise concerns and make a complaint, relevant information was provided at each referral. One person said that staff had supported them when they were not completely satisfied and encouraged to make a complaint to enable staff to follow up and improve matters.

While people’s end of life care needs was not specifically undertaken at the point of referral, the registered manager explained that if this occurred during a care package, the person would continue to receive care and support from Home First.

The registered manager and staff team had a good understanding of the needs of people who used the service and of their responsibilities in notifying us of any incidents. There were systems in place to monitor and check the quality and safety of the service being provided.