Background to this inspection
Updated
10 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 17 May 2017. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to ensure that the registered manager would be present. The inspection was carried out by one inspector. The inspector was supported by an expert by experience who obtained telephone feedback from relatives.
Before the inspection we reviewed relevant information that we had about the provider which included the provider information return pack (PIR). A PIR 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.
During the inspection we spoke to one person who used the service and eight relatives. We also spoke with four support staff, two area managers, a contracts manager and the registered manager.
We spent some time looking at documents and records that related to people’s care and the management of the home. We looked at five people’s care plans and risk assessments.
We reviewed five staff files. We looked at other documents held at the home such as medicines and quality assurance records.
Updated
10 June 2017
This inspection took place on 17 May 2017. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to ensure that the registered manager would be present to provide the information and documents necessary for the inspection.
During the last inspection on 18 January 2016 we found the service was in breach of two legal requirements and regulations associated with the Health and Social Care Act 2008. We found that there were no medicines audits in place across the service, care staff did not have one to one supervision sessions and annual appraisals were not sufficient to support staff to carry out duties they were employed to perform.
Medstar Domiciliary Care service provides care and support for 11 people. Medstar works with people living with dementia, learning disabilities, people with autistic spectrum disorder, and people with sensory and physical impairment.
People and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.
Detailed and current risk assessments were in place for people using the service. Risk assessments were reviewed and updated regularly. Risk assessments explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person whilst supporting them to be independent.
Medicines were now managed safely and effectively and there were regular medication audits in place. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff.
Staff were now receiving regular documented supervisions and an annual appraisal. We saw evidence of a comprehensive staff induction and on-going training programme. Staff were also safely recruited with necessary pre-employment checks carried out.
We received positive feedback from people and relatives regarding the caring and supportive nature of staff.
Care plans were person centred and reflected what was important to the person. Care needs were regularly reviewed and updated to meet the changing needs of people who used the service.
We saw evidence of a comprehensive and on-going training programme.
All staff had received training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and staff understood what to do if they had concerns with regards to people's mental capacity.
People were supported to maintain good health and had access to healthcare services.
The service regularly requested feedback from people who used the service.
People were encouraged and supported to access the community and engage in activities of their choice.
The management team enabled an open culture that encouraged staff to discuss issues and areas for improvement.
The provider had a quality monitoring system to ensure standards of service were maintained and improved.