This inspection took place on 9 January 2017 and was announced. The provider was given 72 hours’ notice in order to ensure people we needed to speak with were available.Northern Home Care Limited is a small domiciliary care agency providing personal care to older people in their own homes. At the time of our inspection the agency was delivering 51 hours of care to seven people. There were two staff (including the registered manager) employed to undertake these hours, plus one bank 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.
During the previous inspection in November 2015 we identified a breach of regulation because care records were poorly organised making it difficult to access important information. At this inspection we checked records and other documentation to ensure that improvements had been made and sustained.
We found that the provider had made the necessary improvements regarding records and that this breach was now met.
At the last inspection in November 2015 we found that people’s care records did not contain sufficient person-centred information for staff to know them. This did not have any obvious impact on the care provided because staff had worked with the same people for a long time and knew them well. However, new staff would require more detailed information to be able to provide high-quality, effective care. We made a recommendation regarding this.
During this inspection we looked at care records and person-centred plans to see if the necessary improvements had been made and sustained. We saw that care records contained plans which were clearly person-centred and focused on people’s independence.
At the last inspection we found that risk assessments were not sufficiently detailed to support staff in providing safe care. We made a recommendation regarding this. During this inspection we checked what progress had been made. The provider had developed risk assessment processes to include a risk screening document. This allowed them to effectively assess a range of risk factors and establish if they required further consideration.
People we spoke with told us they felt safe. The comments that we received from people using the service and a relative regarding safety were very positive.
Northern Homecare had access to sufficient staff hours to cover its responsibilities and was actively recruiting in anticipation of growth. Recruitment procedures adhered to safe-practice guidelines.
The provider had a training plan in place and made use of e-learning to facilitate a range of course which were appropriate to meet the needs of people using the service. These included; Health and safety, equality and diversity, adult safeguarding, dementia awareness and the Mental Capacity Act 2005 (MCA).
We asked about arrangements for staff supervision and appraisal. We were told that because the service was small, there was daily contact and support available. We saw from records that more formal supervision was completed quarterly.
At the previous inspection we noted that information relating to Lasting Powers of Attorney (LPA) was not recorded in people’s care records. We spoke with the registered manager about this who confirmed that none of the people currently receiving a service had an LPA decision in place. They also confirmed that details would be recorded if the situation changed.
We asked people about the support they received to eat and drink. Each of the people that we spoke with said that they had no issues with how staff supported them or the quality of food that was prepared.
People spoke positively about the support they received with their healthcare. We saw notes relating to medical histories and healthcare appointments in care records.
Each of the people that we spoke with was extremely positive about the staff and the quality of care that they received. People told us how they were involved in decisions about their care and how flexible the care staff were. The staff member that we spoke with and the registered manager clearly knew each person and their needs well. They had positive, professional relationships with people and their families.
We asked people if they knew what do if they needed to make a complaint. Each of the people we spoke with told us they had never had to make a complaint, but understood who they should speak to if required.
The provider issued annual questionnaires which gave people the opportunity to comment on performance and suggest improvements. The most recent questionnaires were issued in June and July 2016. Thirty six percent of the questionnaires were returned. In each case the responses were exclusively positive. None of the respondents or the people that we spoke with suggested any areas where the service could improve.
The registered manager was aware of their responsibilities regarding their registration with the Care Quality Commission and demonstrated responsibility and accountability in discussions about the improvements made following the last inspection.
The service operated quality and safety systems that were suited to a small operation and alerted the registered manager to issues and concerns in a timely manner.
The service utilised a basic set of policies and procedures including those for; confidentiality, safeguarding and whistle-blowing. The policies contained sufficient information to inform staff, but had not been subject to a recent, formal review. We spoke with the registered manager about this who confirmed that all policies would be reviewed to ensure that the information and guidance was current and fit for purpose.