This inspection was undertaken on Tuesday 14 June 2016.The Local Care Company is a care agency registered to provide personal care for adults in their own homes. The office is situated on one of the main roads, close to the town centre of Bolton. At the time of our inspection the service provided care and support to approximately 84 people, whilst also employing approximately 50 members of staff.
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 people we spoke with told us they felt safe. The staff we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns.
We found medication was generally handled safely and people received their medicines at the times they needed it. We looked at how medication was handled at the two houses we visited. However, at one of the houses we visited, we found unexplained gaps in the staff signatures on the MAR (Medication Administration Records). We raised this concern with the manager who said they would be addressing this issue with staff.
The service used a call monitoring system. This enabled management and staff in the office to check care was being provided to people at the correct time of day and in line with people’s care package requirements. Staff spoken with didn’t raise any concerns about staffing numbers, with the service also actively recruiting new staff at the time of the inspection.
We saw staff were recruited safely, with appropriate checks undertaken before staff began working with vulnerable adults.
The service used an electronic training matrix to monitor the training requirements of staff. This showed us staff were trained in core subjects such as; safeguarding, moving and handling, medication and health and safety. We saw staff had not undertaken relevant training with regards to Mental Capacity Act/DoLS, although the manager told us they would look to book staff onto this course when they became available. Some other training courses were due for renewal, although the manager confirmed these had been booked for later in the year.
People told us staff helped them to maintain good nutrition and hydration. People said staff always left them with something to eat and drink before leaving their house.
We saw staff received regular supervision as part of their on-going development. This provided an opportunity to discuss their workload, concerns and training opportunities. We saw records were maintained to show these took place.
The people we spoke with told us they were happy with the care provided by the service. People told us staff treated them with dignity and respect and promoted their independence as much as possible.
Each person who used the service had a care plan in place and we saw a copy was kept in the person’s home and at the office. We looked at four care plans during the inspection. These were lacking in person centred information and did not contain sufficient information about people’s life histories, likes and dislikes. The tasks to be completed by staff were brief and did not contain information about how people liked their care to be delivered. This was a breach of regulation 9 (1) (c ) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to person centred care.
The service also sent satisfaction questionnaires to people, asking for their feedback about the service. We saw that where negative comments had been made, the service responded appropriately.
There was a complaint procedure in place. We saw complaints were responded to appropriately. The service user guide also clearly described the process people could follow if they were unhappy with the service they received. Many people had also made compliments about the service they received.
People who used the service and staff told us they felt the service was well managed,. Staff told us they felt well supported and would feel comfortable raising and discussing concerns.
We saw there were systems in place to monitor the quality of service provided. This was done in the form of regular spot checks and observation of staff undertaking their work.