Background to this inspection
Updated
24 November 2021
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. 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 notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service about their experience of the care provided. We also spoke with two family members of people who use the service, three members of care staff, the registered manager, the deputy manager and the administrator.
We reviewed a range of records. This included five people’s care records and medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
24 November 2021
About the service
A Little Extra Help is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 7 people were receiving the regulated activity of personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found.
Staff were not always fully trained. The induction training package did not cover the basic training required for staff working in care, to ensure they were competent to care for vulnerable people.
Safe employment checks were not always carried out. The service had taken on staff from another domiciliary care agency which had closed, but checks on their recruitment were not all complete.
Care plans were in place and described the risks present in people’s lives, but associated risk assessments had not always been completed to explain the detail of the risk, and mitigating measures.
Care plans contained sufficient information about people’s routines and care tasks, but more person centred information was required to detail people’s likes, dislikes, personal history and personality.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; However, the policies and systems in the service were not always clear. The registered manager told us all the people receiving a regulated activity had full capacity, but there were no care plans in place which detailed capacity, and how this was assessed.
Audits were taking place in some areas, but oversight was not sufficient enough to pick up the problems within staff training, employment checks, and risk and capacity assessment.
Medicines were managed safely. People were encouraged to manage their own medicines as much as possible to promote independence.
People were protected from the risk of infection.
There were enough staff available to meet people’s needs. Staff received support and supervision to ensure people’s needs were met.
Accidents and incidents were recorded and monitored by the management team. Lessons were learned when things went wrong.
Peoples needs were assessed prior to the service conducting care.
People were supported to maintain a healthy balanced diet.
The service worked in partnership with health care professionals. People were accessing health care services as and when needed.
People were involved in the planning of their care. Systems were in place to support effective communication.
A complaints policy and procedure was in place, and people knew how to use it.
People had developed good relationships with the staff and management team and staff respected people’s privacy and dignity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 06 August 2020 and this is the first inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to staff training and general oversight of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.