Background to this inspection
Updated
13 October 2016
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 1 and 2 September 2016 and was announced. We gave the service short notice because we wanted to meet the registered manager and needed to be certain they would be available during the inspection. This also gave the registered manager sufficient time to ask some people if they would be willing for us to visit and speak with them in their homes. The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the provider completed 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. We looked at the information in the PIR and also looked at other information we held about the service before the inspection visit.
During this inspection we went to the provider’s office and spoke to the registered manager, training manager and care co-ordinator. We looked at a range of records the provider is required to maintain. These included four service user support plans, medicine administration records, staff rotas, four staff recruitment files, staff training records and quality monitoring records. We also looked at records of accidents, incidents, compliments and complaints and safeguarding investigations. We spoke to one care worker in the office and four care workers on the telephone. We visited four people with their permission in their own homes and undertook phone calls to six people that used the service.
Updated
13 October 2016
The inspection took place on 1 and 2 September 2016 and was announced. The service was previously inspected on 22 and 23 January 2014 when we found the service was fully compliant with all regulations covered in the inspection. During this inspection we found no breaches of regulations and we found people received a good service.
Purple Balm (Exeter) domiciliary care agency is a domiciliary care agency which provides personal care to vulnerable adults in the community, the majority living in the Exeter area. The service provision varies from half hourly visits daily to the provision of 24 hour care for people living in their own home. The agency also provides staff to work in residential and other social care settings; however we did not inspect this aspect of the service as there is no requirement for it to be registered. The registered manager told us personal care support was currently being provided to approximately 60 people.
There was a registered manager 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 was accessible and approachable. Staff, people who used the service and relatives felt able to speak with the manager and provide feedback on the service. There were systems in place to monitor the quality of the service, including regular spot checks, audits and annual satisfaction surveys for people who used the service and staff.
Comprehensive risk assessments had been carried out, however, this was in a tick box format which did not always include detailed guidance for staff to minimise the risks. Despite this lack of detailed information, people told us staff were well informed about any risks and how to keep them safe, and no accidents or incidents had been documented in people’s homes.
Some care plans had not been reviewed to reflect changes in people’s support needs, although staff had been kept informed via an update sheet in the persons file, and emails, texts and phone calls. People confirmed staff had a good understanding of their needs and were well informed about the care to be provided. Plans were in place to review the risk assessment process and complete outstanding care plan reviews once a new operations manager had been appointed.
People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. The majority of people had a consistent staff team. The agency ensured people were notified promptly of any changes, so they always knew who would be coming and when.
The registered manager told us the service had been through a challenging time related to the retention of some management staff. This had impacted on the frequency of staff supervision. The registered manager ensured staff continued to be well supported, and staff confirmed this was the case. They received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People told us they liked the staff and looked forward to the staff coming to their homes. Comments included, “I can’t say anything wrong about them. They are really, really lovely people, they do listen to you,” and, “I’d recommend them to everybody. They’ve got time for you; they do exactly what you want them to do. They cheer you up as well. We have a chat about things and a bit of a laugh”.
Where required people were supported, as part of their care package, to access food and drink and maintain their nutrition and hydration according to their needs and preferences.
We were told by people using the service that most of their health care appointments were co-ordinated by themselves or their relatives. However, staff were available to support people to access appointments if needed and liaise with health and social care professionals involved in their care if their health or support needs changed.
The registered manager and staff team were proactive in keeping their knowledge and skills up to date and using this knowledge to improve the lives of the people they supported. They were also working to develop constructive links with the community by raising money for charities.