27 January 2016
During a routine inspection
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.