Care At Home

Updated 7 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 inspection took place on 9 and 25 October 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would available. The inspection was carried out by an adult social care inspector and on the first day of the inspection with a specialist advisor SpA). The specialist advisor at this inspection was a pharmacist. The second day was carried out by an adult care inspector.

We had received a Provider Information Request (PIR) from the service, which gave us information about the service and what plans were in place to make continuous improvements. This information was dated and covered the previous arrangements with Project Smile and when personal care was provided to adults outside of the Heathlands Village. Before our inspection we contacted the local authority safeguarding team who raised no concerns with us.

During our inspection we spoke with five people who used the service, the team leader and two members of staff. We also looked at medicines management, care records and risk assessments.

Updated 7 March 2019

This inspection was announced and took place on 9 and 25 October 2018.

There has been a change to the way the service is delivered since our last inspection. The service used to be called Project Smile and Care at Home. Since our last inspection a decision was made to stop providing support to children and adults living within the local community and the service was renamed Care at Home.

This service is a domiciliary care agency. It provides personal care to people living in their own flats. It provides a service to older and younger adults.

Care at Home staff provide personal care and support to people that live in their own homes on Moorview, which is sited within The Heathlands Village. At the time of our inspection visit 31 people were living on Moorview, 18 of whom were receiving personal care and support from the Care at Home staff team. People who used the service who received support had a wide range of diverse needs.

People were able to access all the facilities available on The Heathlands Village site and many of the systems and processes used by the Care at Home staff were the same as The Heathlands Village and are therefore shared in this report.

At our last inspection in November 2015 we rated the service as 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. 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 did not have a manager who was registered with us. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of this inspection a new manager had recently been appointed and their application to register was submitted after the inspection.

Staff we spoke with praised the outgoing manager for the work they had done in promoting good teamwork and raising confidence which had a positive impact on morale.

Recruitment procedures were satisfactory. However, improvements were needed to the registered providers application form to ensure a full employment history was maintained. This was addressed by the provider during our inspection.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe. They told us they were certain any concerns would be taken seriously by the managers of the service.

Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were available to support people.

Risk assessments had been put in place and were individual to the person assessed. This was to minimise potential risk of harm to people during the delivery of their care and support. These had been reviewed on a regular basis and were relevant to care provided.

We found medication procedures at the service were safe. People were supported to maintain good physical and mental health through regular monitoring by staff and support to attendance at external appointments.

People were supported to have maximum choice and control of their lives with staff support where necessary. People who used the service were responsible for cleaning their own flats, with support.

Staff told us they received the training and supervision they needed to be able to carry out their roles effectively. Improvements had been made in staff training and more support was being offered to staff from human resources to improve staff retention.

Most people chose to access the facilities on the Heathlands Village site such as the café and restaurant for their main meal of the day. People enjoyed the food that was offered which, were overseen by the Manchester Beth Din and the religious director for the service to ensure that religious and cultural requirements were met.

People’s religious needs were met on site. We saw that Yiddishkeit (Jewish customs and way of life practices) had been further promoted with more work planned.

People told us and we saw that there were frequent and friendly interactions between People and members of the staff team.

Care plans were in place to help ensure staff provided the level of support necessary to manage identified risks. Care plans were regularly reviewed to address any changes in a person’s needs.

People were encouraged to participate in the wide range of activities available on the Heathlands Village site and also separate activities provided on Moorview.

People who used the service knew how to raise a concern or to make a complaint. People had raised concerns recently about the increase in maintenance charges. People were actively encouraged to give their views and raise concerns or complaints. The registered provider saw concerns and complaints to help drive improvement and were discussed at a high level.

The service had developed a clear and visible code of practice that supported a positive culture and value base. This was expected to be followed by all people connected with the Heathlands Village.

The registered provider used a variety of methods to assess and monitor the quality of care.