Background to this inspection
Updated
23 November 2018
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 was an announced, comprehensive inspection carried out by one inspector. Inspection activity started on 28 September 2018 when we visited the office premises and ended 12 October 2018 when we gave feedback.
The provider was given 48 hours’ notice because we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to make arrangements with people so that we could visit them in their homes to find out their experience of the service.
As part of our inspection planning, we requested that the provider 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. This was received from the provider. We also reviewed information we held about the service including feedback sent to us from other stakeholders, for example the local authority and members of the public. Providers are required to notify the Care Quality Commission (CQC) about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters. We reviewed the notifications the provider had sent us.
During the inspection we spoke with the provider’s nominated individual, the registered manager, the deputy manager and ten care workers. We reviewed the care records of six people to check they were receiving their care as planned. We looked at records relating to the management of the service, staff recruitment and training, and systems for monitoring the quality of the service.
On 4 October 2018 with their permission, we visited three people who used the service and a relative in their own homes. On 9 October 2018 we carried out telephone interviews and spoke to three people who used the service and three relatives. We also received feedback from three community professionals.
Updated
23 November 2018
Caring Moments Limited is a domiciliary care agency. It provides personal care to people who live in their own houses or flats. It provides a service to adults. Not everyone using Caring Moments Limited 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 on 5 and 11 July 2017, we found a breach of Regulation 19 of the Health and Social Care Act 20018 (Regulated Activities) Regulations 2014. Improvements were needed to establish safe and robust recruitment systems. We rated the service overall requires improvement. The key questions safe, responsive and well-led were rated requires improvement. The key questions effective and caring were rated good. Following the inspection, the provider sent us an action plan detailing how the shortfalls would be addressed.
At this announced, comprehensive inspection 28 September 2018, we found that improvements had been made in most areas and therefore, the provider was no longer in breach of any regulations. The overall rating for the service has now changed from requires improvement to good.
At the time of this inspection, there were 33 people who used the service and received ‘personal care’. The provider was given 48 hours’ notice because we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to seek agreements with people so that we could visit them in their homes to find out about their experience of using the service.
At this inspection, we found that improvements had been made and were ongoing. A registered manager was now in post. 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.
The registered manager had implemented systems to monitor the quality and safety of the service provided. Recording, auditing and documentation in these areas had recently been improved. However, these were not yet fully embedded into practice and at the time of the inspection we were unable to assess their effectiveness. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of safe, caring, responsive and well led to at least good. At this inspection we found that improvements had been made in most areas and therefore, the provider was no longer in breach of any regulations. The overall rating for the service has now changed from requires improvement to good.
People and their relatives had developed good relationships with the care workers and management team. People received care that was personalised and responsive to their needs. They expressed their views and care staff listened to what they said and ensured their opinions were acted on.
People’s care records were accurate and reflected the support provided. Care workers consistently protected people’s privacy and dignity.
People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Systems were in place to minimise the risks to people, including from abuse, and in relation to mobility, nutrition and with accessing the community. Care workers understood their roles and responsibilities in keeping people safe.
Recruitment checks were carried out with sufficient numbers of care workers employed. They had the knowledge and skills through regular supervision and training to meet people’s needs.
Where people required assistance with their medicines, safe systems were followed. Care workers were provided with training in infection control and food hygiene and understood their responsibilities relating to these areas. Systems were in place to reduce the risks of cross infection.
The service worked in partnership with other agencies. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment. Where required, people were safely supported with their dietary needs.
There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. As a result, the quality of the service continued to progress.