Background to this inspection
Updated
24 October 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
This inspection was completed by one inspector and one 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats, and specialist housing.
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 the service 24 hours’ notice of the inspection. This was to ensure the registered manager would be available to speak with us.
Inspection activity started on 18 September and ended on 26 September. We visited the office location on 19, 24, and 26 September.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with seven people or their relatives over the phone. At the office, we spoke with six members of staff including the registered manager, deputy manager, office and care staff. We reviewed care plans and records for four people, as well as other records relating to the care people receive. We looked at five staff recruitment files and other records about the management of the service.
After the inspection
We wrote to two social care professionals and they provided us with written feedback about the service.
Updated
24 October 2019
About the service
Autonomy Care Limited is a domiciliary care agency providing personal care to 22 people in their own home, at the time of the inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related 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
At the last inspection the service was rated as outstanding for caring. At this inspection, we found examples of outstanding care had continued. People had been supported to engage with their family at important events and to make friendships. Staff understood the importance of supporting people to achieve positive outcomes. People spoke of staff as being kind, caring and respectful.
People told us they felt safe. They told us there was usually a regular team of care staff and they mostly knew who to expect. Staff were appointed subject to satisfactory background, employment and character reference checks.
Where there were potential risks to people’s safety and wellbeing, these were assessed, and risk-reducing measures were put in place for staff to follow. Staff understood their responsibility to recognise and report any safeguarding concerns. Staff had received safeguarding training.
Medicines systems were well managed. There were clear protocols in place to guide staff in administering people’s medicines safely. Medicine records reviewed were up to date and accurate.
People’s care plans reflected their needs and choices. There were plans in place for specific healthcare needs such as epilepsy, with clear guidance for staff to follow. There were efficient processes in place to update staff and the person’s care plan in the event of any changes in the person’s support needs.
People told us staff talked through everything they were supporting them with and sought their consent. People told us they felt the care staff were caring and respectful.
Where complaints and concerns had been received, these had been investigated and responded to appropriately.
People were invited to share their feedback with the service through reviews and surveys. The most recent survey results were mostly very positive. Where there were less positive comments, the management team followed up on these to see what could be done to make things better.
Staff received a range of different training. This included mandatory training such as equality and diversity and safeguarding.
Where people lacked the mental capacity to consent to decisions about their care, this was assessed in accordance with the principles of the Mental Capacity Act. People were supported to have choice and control of their lives and staff supported them in their best interests; the policies and systems in the service supported this practice.
The registered manager had plans for the future development of the service. Staff felt supported by the registered manager.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drives of improvement. As part of thematic review, we considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
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 18 January 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.