Remark! Living

Updated 24 May 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: This inspection was carried out by one ASC inspector who was supported by two British Sign Language (BLS) interpreters.

Service and service type: Remark! Living is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community.

The service had a manager registered with the Care Quality Commission (CQC). This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: We gave the service 5 days’ notice of the inspection site visit[s] because people using the service and staff employed could communicate only in BSL. This meant that we had to arrange for people and staff to meet us at the service during the inspection to give their feedback about the service.

What we did:

Before the inspection: We asked the provider to complete 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 completed PIR and previous inspection reports before the inspection. We reviewed other information we had about the provider, including notifications of any safeguarding concerns or other incidents affecting the safety and wellbeing of people.

During the inspection: An inspection site visit took place on the 30 April 2019. It included speaking to the registered manager, the care coordinator, the senior communications support officer, one person using the service and three staff members. During the inspection we reviewed three people's care records, which included care plans, risk assessments and daily care notes. We also looked at medicines administration records (MARs) for one person, four staff files, complaints and quality monitoring and audit information.

What we did after the inspection: Following our visit, we contacted a number of health and social care professionals who worked regularly with the agency. We received feedback from one of them.

Updated 24 May 2019

About the service: Remark! Living is a home care service that provides care and support to people in their own homes. They work with hearing impaired British Sign Language (BSL) people who are elderly, disabled or have additional needs to help them remain independent at home. At the time of the inspection there were 3 people using the service.

People’s experience of using this service:

Remark! Living provided safe care to people who use the service. There were systems in place to ensure people were protected from avoidable harm. These included appropriate safeguarding procedures, regular risk assessment and risk management processes and safe staff recruitment.

People’s medicines were managed safely, and people received their medicines when needed.

There were enough suitable staff deployed to support people as agreed.

People’s needs, and preferences had been assessed before the service commenced. People and when appropriate their relatives were involved in planning and reviewing the care and the support provided by the service.

Each person had an up to date, person centred care plan that described people’s care needs and preferences. It also included basic information about who people were and what they liked to do. Staff held regular conversations with their managers on how to best support people in meeting their needs and achieving their goals. This included advocating for people when needed and accompanying them to various leisure activities in the community.

Staff asked for people’s consent before they provided care to people. Staff said involving people and helping them to progress and be independent as much as possible was an important part of the service provided.

People were supported to live a healthy life. When required staff helped people to have a nutritious diet that met people’s dietary needs and preferences. Staff supported people to have access to health services when needed.

Staff had appropriate skills and received suitable training to support people safely and effectively. Regular supervision and spot checks by the managers ensured care provided by staff was monitored and improved if needed.

People and relatives were happy with the support provided by the service. They described staff as caring and kind. Staff knew how to communicate with people in the way people could understand and respond to. Staff respected people’s privacy and dignity when providing personal care.

The service promoted equality and inclusion ensuring everything possible was done to help people to receive the support they needed.

There was a positive team ethos that promoted an open communication and supportive working environment.

The managers knew their roles and responsibilities. They managed the service effectively to ensure it met all the Requirements of the Social Health and Care Act (Regulated Activities) Regulations 2014. Appropriate checks were carried out by the managers to ensure that the service and staff performance was monitored.

People using the service and their relatives were involved in planning, reviewing and monitoring of the care provided. The outcomes of the latest satisfaction survey showed that people were satisfied with staff and the care they received.

Rating at last inspection: Good (last report published on 02 January 2017)

Why we inspected: This was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor the service and we will revisit it in the future to check if they continue to provide good quality of care to people who use it.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk