Background to this inspection
Updated
15 February 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 inspection took place on 6 November 2017 and was announced. We told the registered manager forty-eight hours before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. Two inspectors undertook the inspection, with an expert-by-experience, who had experience of older people’s care services. The expert by experience helped us with the telephone calls to get feedback from people being supported.
We previously carried out a comprehensive inspection on 30 September and 9 October 2015 and no concerns were identified.
Before the inspection, we reviewed information we held about the service. This included previous inspection reports, complaints and any notifications. A notification is information about important events which the service is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.” We contacted the local authority commissioning team and to ask them about their experiences of the service provided. We contacted four health and social care professionals for feedback on the service provided and received three responses. We spoke with 15 people who used the service and two friends.
During the inspection we went to the service’s office and spoke with the registered manager, two operations managers, two care support managers, the manager of the duty team, a duty officer, the manager of the administrative support team and five care staff. We spent time looking at records, including eight people’s care records, five staff files and other records relating to the management of the service, such as policies and procedures, accident/incident recording and audit documentation. We also ‘pathway tracked’ the care for some people using the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.
Updated
15 February 2018
The inspection took place on the 6 November 2017 and was announced.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults, but predominantly to older adults, including people who may have a physical disability, a learning disability, sensory loss, mental health problems or people living with dementia living in Brighton and Hove. This is a responsive short-term reablement service for people who need support to regain their independence, but do not require any clinical care. Care and support is also provided for a small number of people who have complex care needs and receive long term care and support. At the time of our inspection around 80 people were receiving a service.
At the last inspection on 30 September, and 9 October 2015 the service was rated overall Good. At this inspection we found the service remained overall Good. At the last inspection the needs and choices of people had been clearly documented in their care and support plans. Where people’s needs changed, people’s care and support plans were reviewed to ensure the person received the care and treatment they required. However, the detail in people’s care and support plan was variable. At this inspection we found work had been undertaken to address this. People also told us they did not always have continuity of care staff providing their care. Feedback at this inspection was where possible this had also been addressed.
Systems had been maintained to keep people safe. People told us they felt safe with the care provided. People’s comments received included, “Lost my confidence going down stairs so they have helped me feel safe again, ”and “It’s like having a friend come in to help and keep you safe.” They knew who they could talk with if they had any worries. They felt they could raise concerns and they would be listened to. People remained protected from the risk of abuse because staff understood how to identify and report it. Assessments of risks to people had been developed. Staff told us they had continued to receive supervision, and be supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. One member of staff told us, “We are backed up very well by the office and managers. They are always only a phone call away. I’ve always been well supervised, every four to six weeks. They are hot on training. I’ve got NVQ Level 3, and done dementia awareness.” People told us care staff had the knowledge and skills to provide their care and support.
People's individual care and support needs continued to be identified before they received a service. Care and support provided was personalised and based on the identified needs of each person. People told us they felt listened to, supported to be independent and they were involved in decisions about their care. One person told us, “Carers have nice smile, put you at your ease, they have a very nice way allowing you to do things for yourself but not making you feel you ought to be able to do it and not rushing in just waiting for you to need help. It’s part of their professionalism you always feel like they are watching to keep you safe.” Staff had a good understanding of consent.
People were happy with the care provided. People continued to be supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. People’s comments included, “Can’t speak highly enough of the carers, brilliant people, didn’t know there were people like that around,” and “Can’t speak highly enough of the carers. Glad they are employed by Brighton and Hove Council which gives them good terms of employment. They are cheerful, willing flexible, if you need an extra ten minutes that’s OK. They say, and I believe them, that they love their work they are so caring.”
People told us they were supported to be independent. One person told us, “The management seem very sincere. They have recently visited to assess what is needed in the future and it was like talking to a friend walking along together doing the journey together.” Another person told us, “It’s personalised, it’s reliable, it’s good humoured, sensitive to my needs, unrushed and careful.”
The provider continued to have arrangements in place for the safe administration of medicines. People were supported to get their medicine safely when they needed it. If needed, people were supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health.
People and staff told us the service continued to be well led. People’s comments included, Excellent service When I had my hip replacement and excellent service this time, very satisfied,” “Friendly and caring,” and “Marvellous service.” Staff told us the registered manager was always approachable and had an open door policy if they required some advice or needed to discuss something. Senior staff carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted about the care provided through reviews and by using quality assurance questionnaires.