Grayson Home Care Ltd

Updated 5 December 2018

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 30 October 2018 and was announced. We told the provider we would visit on 25 October 2018. They were given notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office. Inspection site visit activity started on 30 October 2018 and ended on that date. We visited the office location to see the manager and office staff; and to review care records and policies and procedures. We contacted staff, people and their relatives by telephone on 8 November 2018.

The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed information we held about the service. This included notifications the provider had sent us about events or incidents that occurred and which affected their service or the people who used it. We contacted the local authority adult safeguarding and quality monitoring team as well as Healthwatch, the consumer champion for health and social care, to ask if they had any information to share. We used this information to plan our inspection.

We did not ask the service to complete a Provider Information Return before this inspection. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with three people who used the service and two relatives for their feedback. We spoke with the registered manager and four members of staff. We looked at four people's care plans, risk assessments, daily notes and medication administration records. We reviewed four staff's recruitment records, as well as training, supervision and appraisal records for the staff team, and meeting minutes, audits and a selection of other records relating to the management of the service.

Updated 5 December 2018

This inspection took place on 30 October 2018 and 8 November 2018 and was announced. At our last inspection in November 2015, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Grayson Homecare provides domiciliary care services to adults and older people with varying needs living locally to the service. The office is staffed daily to cover business hours and an out of hours phone service is also available. At the time of our inspection the service was providing personal care to 43 people.

Not everyone using Grayson Homecare receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager. 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 2008 and associated Regulations about how the service is run.

The registered manager continued to oversee the service provided to people. Throughout discussion the registered manager demonstrated a thorough knowledge of people using the service and the staff team. The registered manager was supported by a team of office based staff and care staff who provided care and support to people in their homes.

Staff we spoke with clearly explained how they saw the overall culture and aims of the service, explaining that the support provided for people was their priority. Staff told us the registered manager always provided support and expected staff to be friendly, approachable and treat people with dignity and respect.

The registered manager had systems in place to monitor the quality of the care provided and make improvements to the quality and safety of the service. These included audits on areas covering care records and medication records.

People continued to remain safe as staff knew how to recognise and respond to concerns of ill-treatment and abuse. The provider followed safe recruitment procedures when employing new staff members. When people needed it, they were safely supported with their medicines by trained and competent staff members.

The provider followed effective infection prevention and control guidance when supporting people in their own homes. The equipment that people used was maintained and kept in safe working order and the provider undertook safety checks with people at their home addresses.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People's needs were assessed before they started using the service. Care and support plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. The plans made good use of personal history and described individuals care, wellbeing and support needs. Staff knew the people they were supporting and provided a personalised service.

People were protected from the risk of poor nutrition and staff were aware of people's nutritional needs. People were supported during visits to and from external healthcare specialists.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of how to make a complaint.

The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers and ensured people's transfer between services was planned safely.