Background to this inspection
Updated
8 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 carried out by one inspector and an 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 apartments or suites.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 4 and ended on 9 September 2019. We visited the office location on the 4 and 5 September 2019.
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 11 people who used the service about their experience of the care provided. We spoke with six members of staff. We also spoke with the general manager, manager and trainer.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
8 October 2019
About the service
Richmond Village Painswick DCA provides care and support services to people living in their own homes within the Richmond Village retirement complex. People live in the independent living apartments or in the assisted living building known as “suites”. 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 services provide this help, we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they felt safe with the staff. The staff had attended safeguarding of abuse training and were aware of the procedure to follow when there were concerns of abuse.
Systems were in place to manage risk. Where risks were identified individual risk assessments were in place. Risks were reviewed and updated when people’s needs changed. There was an overarching register of people at greatest risk of potential harm which ensured their needs were kept under review.
Environmental risk assessments were in place and detailed. We recommend copies of personal evacuation plans to be kept in people's homes to ensure their awareness of the emergency plans.
Medicine systems were safe. Medicines were audited and action plans were developed where gaps were identified.
People told us there were sufficient staff on duty. They said their visits were not missed and the staff stayed for the agreed times.
There was an online system of recording accidents and incident. Reports were analysed and follow up action taken as required. The staff discussed accidents and incidents to ensure there was learning to prevent re-occurrences or to better manage situations of the same nature. The staff were positive about the team and that they were able to learn from shared experiences.
People needs were assessed before the agency agreed to deliver personal care.
Staff were supported with their roles and responsibilities. New staff had an induction when they started work at the agency. There was mandatory training set by the provider which staff attended.
The staff were supported with their performance and development. Performance was monitored through one to one supervision, observations and annual appraisals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.
Some people had nominated a lasting power of attorney (LPA) for finance or care and treatment. However, copies of the LPA were not kept on file. The manager had not checked to confirm the validity of the LPA. This meant the manager was unclear on who were the decision makers to participate in best interest decisions when people lacked capacity. We recommend the manager ensures LPA were accurately documented
Care plans were person centred and reflected people’s personal care needs. Peoples care needs were reviewed six monthly to ensure their needs were met as they changed. Where people lived with mental health needs their care plans were not updated when there were signs of deterioration. The manager took appropriate action to review the care needs of people with mental health care needs.
People arranged their own healthcare. Where health care visits had taken place, the staff recorded the nature of the visits and their outcome in the communication book.
People said the staff were caring and kind. The staff knew the importance of developing relationships with people. Their comments showed they knew people's preferences and had an insight into people's life stories.
Quality assurance systems were effective. There was a wide range of audits undertaken and action taken where there were shortfalls. Complaints were investigated and resolved to a satisfactory level.
The staff said they felt valued by the manager and there were opportunities for personal development.
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 (16 March 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.