We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This inspection was completed by one inspector. They visited the office and also a person in receipt of personal care. This is a summary of what we found based on our observations, speaking with a person who used the service, talking with three staff and looking at records.
Is the service safe?
A person told us they felt safe with the team of staff supporting them. They were confident if they had any concerns the provider would listen to them and respond in a timely fashion. Staff spoken with told us how they would recognise abuse and how they would report it. They were aware of which other agencies and professionals needed to be alerted to alleged abuse.
A person told us they were fully involved in the assessment of their needs and care planning. They had discussed any hazards to them or in their home. They were confident staff understood these and how to support them safely. We found hazards were identified but records were not clear how these were being minimised. Systems were in place to record accidents and incidents although there had been none to report.
Recruitment practice was ineffective. All of the necessary checks were not being completed. Some staff files did not have copies of the application form. On the application forms we looked at there were gaps in employment history and the reason why people had left previous employment in care had not been obtained. The character and fitness of staff were not being checked to make sure they were able to do the work. This could potentially put people at risk of harm.
Is the service effective?
People were given information about the service they could expect to receive. A person told us,"the care is excellent, they look at the whole person". We observed a person being treated with dignity and respect. They confirmed care records reflected their wishes and preferences about how their personal care was to be delivered. Systems were in place to review these records.
Staff spoken with had a good understanding of people's needs. New staff completed induction training to equip them with the skills and knowledge to meet people's needs.
Is the service caring?
Staff spoken with were caring and professional about their role and the people they supported. A person told us the service they received was 'tremendous' and 'reassuring'. The provider had also received feedback from other people they supported including, 'your valuable contribution is appreciated'. One relative commented they had seen considerable improvements in their relative since the provider had been supporting them.
A person told us their care was provided in accordance with their preferences and wishes. They said they were able to do things at their own pace and this was really important to them.
Is the service responsive?
An assessment was completed to make sure people's needs could be met. Reviews took place to keep this assessment up to date. A person told us if there were changes in their care needs the provider took action in a timely fashion. There were systems in place for staff to raise concerns about changes in people's needs with the provider. They said the provider would take the necessary action.
People were given information about how to make a complaint. A person said they would talk to staff or management if they had any concerns. They were confident they would be listened to and they would have an appropriate response.
A person told us they had made suggestions to the provider and these had been considered and put into action. Staff also commented that they felt they could influence change within the agency.
Is the service well led?
People and staff said they had made suggestions to the provider which had resulted in improvements to the service delivered. A quality assurance system was being developed which included feedback from people who used the service and staff. The provider checked on the quality of service provided by observing staff practice. They were also developing a range of monitoring and audit tools.
Staff had a good understanding of their roles and responsibilities. They said communication with the provider was robust and they felt well supported. They said management were always available whether in person or over the telephone.