Background to this inspection
Updated
5 November 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. 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
The inspection team consisted of one inspector and one assistant inspector. An expert by experience also supported in making telephone calls to people who used the service in order to gain their views. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 a short period notice of the inspection because we needed to ensure people had consented for us to make home visits and to be contacted by our Expert by Experience.
Inspection activity started on 3 October 2019 and ended on 14 October 2019. We visited the office location on 3 and 4 October 2019.
What we did before the inspection
Before the inspection we reviewed information we already held about the service. This included reviewing information we had received from the provider as notifications. Notifications are information about events that providers are required by law to tell us about.
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-
During the inspection we spoke with 13 people who used the service and 12 relatives over the telephone about their experience of the care provided. We also completed two home visits to people receiving care and support. We received feedback from one external healthcare professional. We spoke with and received feedback from five care staff, three care coordinators, the deputy manager, the registered manager and the operations director.
We reviewed a range of records. This included reviewing 12 care records for people receiving support including their care plans, risk assessments and medicine records. We looked at six staff files in relation to recruitment and supervision and reviewed a number of other records relating to the management of the service, such as accidents and incidents, audits, company policies, complaints and staff training.
After the inspection –
We continued to seek clarification from the registered manager to validate and follow up on evidence we found. We looked at training data and quality assurance records. We received further information requested during the inspection.
Updated
5 November 2019
About the service
Care at Home Services (South East) Limited – Bexhill, referred to as Care at Home in this report, is a domiciliary care agency providing personal care to approximately 183 people at the time of our inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks relating 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
Care at Home had strong person-centred values and placed people at the heart of their work. People had access to staff who knew them well and achieved positive outcomes and strong relationships.
People were supported by kind and caring staff who worked hard to promote their independence and sense of wellbeing. People told us they enjoyed the company of staff with comments including; “They give me lots of company; we have a lot of laughs. I look forward to them coming”, “I adore my carer” and “It’s like having friends arrive, they are all very kind, I can’t fault the carers.”
Most people and relatives spoke highly of the overall service they received from Care at Home. People made comments including; “I would recommend the service. They are all really helpful; can’t fault them. Nothing is any trouble” and “I would recommend the company to others; they are very good. I would and do trust them.” A small number of people we spoke with were not as complimentary and raised concerns with us relating to rota changes and the responsiveness of the office. These concerns were shared with the registered manager who provided us with assurances and told us they would look into these people’s complaints further.
People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable to abuse and avoidable harm.
Risks to people’s health, safety and wellbeing were assessed and action was taken to minimise the risks. During our inspection we identified some shortfalls in the detail available within people’s risk assessments and management plans. We also identified staff lacked clear accessible guidance relating to ‘as required’ medicines. However, immediate action was taken to improve in these areas, staff were knowledgeable about people’s needs and people were confident staff were competent when managing their medicines.
People were fully involved in their care and their wishes were respected. People’s views were sought and their consent was always gained before any care took place. 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; the policies and systems in the service supported this practice.
There was strong leadership at the service and people, relatives and staff spoke highly of the registered manager. There was a positive culture at Care at Home and staff felt their voices were listened to.
Care at Home’s management team were passionate about improving the service and had plans for future projects to benefit people. There were quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.
We have made a recommendation about comprehensive risk assessments being in place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection – The last rating for this service was Good (published 14 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.