Background to this inspection
Updated
29 March 2016
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 27 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure the provider had care records available for review had we required them. The inspection was carried out by one inspector.
As part of planning the inspection we asked the provider to complete a Provider Information Return (PIR). This 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 and we took this into account when we made the judgements in this report. We also checked if the provider had sent us any notifications. These contain details of events and incidents the provider is required to notify us about by law, including unexpected deaths and injuries occurring to people receiving care. We used this information to plan what areas we were going to focus on during our inspection.
During our inspection we spoke to the registered manager. We looked at a sample of records including four people’s care plans, two staff files and staff training records to identify if staff had the necessary skills and knowledge to meet people’s care needs. We looked at the provider’s records for monitoring the quality of the service to see how they responded to issues raised.
After our visit we spoke with two people who used the service, the relatives of two other people and with three workers who provided care.
Updated
29 March 2016
The inspection took place on 27 January 2016 and was announced.
The service, at the time of our visit, provided domiciliary care, including nursing care to four adults and two children in their own homes. Some of the people using the service had complex healthcare needs. The service carries out reablement and palliative care when needed.
There was a registered manager at this location. 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 and associated Regulations about how the service is run.
People told us that they felt the service kept them safe. Staff knew how to protect people from the risks presented by their specific conditions and there were details of these risks in people’s care plans.
There were enough staff to keep people safe and to meet their needs. The registered manager conducted checks when staff joined the service to make sure that they were suitable to support the people who used the service.
People who required assistance to take their medication said they were happy with how they were supported. Staff supported people to take their medication in line with their care plans.
Staff had the skills and knowledge they needed to meet people’s care needs. Staff received observations of their practice and supervisions to ensure they remained competent to support people in line with their care plans.
People, and in the case of children, their parents, were involved in reviewing the care provided and had consented to how it was delivered. Staff knew how to support people in line with these wishes.
People who needed support at mealtimes told us that staff supported them to eat and drink enough to stay well. People had access to other health care professionals when necessary to maintain their health.
Some people had developed positive relationships with the staff who supported them and spoke about them with affection. Staff knew the appropriate action to respect people’s privacy and dignity.
People told us how the service would respond if their needs and views changed. We saw that the manager had made many changes in some cases in response to requests. We saw that records were updated to reflect people’s preferences.
The provider had systems in place to support people to express their views about the service and people were aware of the provider’s complaints process. People felt their concerns were usually sorted out without the need to resort to the formal process.
The registered manager had clear views of how they wanted to develop and improve the quality of the service. People who used the service and staff we spoke with provided examples of improvements which the manager had made since joining the service.
The provider had processes for monitoring and improving the quality of the care people received. The registered manager reviewed incidents and comments for trends in order to identify areas for further improvement.