This inspection was announced and took place on 6 and 8 September 2016. We told the provider two days before our visit that we would be coming. This was because we wanted to make sure the information we needed would be available. The inspection was carried out by one adult social care inspector. Agency Assistance provides personal care for adults of all ages. Most of the people live in shared,
supported living houses in Exmouth and surrounding areas. They also provide care to people living in their individual homes. At the time of our inspection, 22 people were being supported with personal care by Agency Assistance in ten locations. This is the part of the service we inspected as it is a regulated activity. The provider also operates a care agency service which provides care workers to other providers. They also run a day centre five days a week in the local area called ‘Happy Days’ where people they support can attend. The provider employed 115 staff the majority of whom could work with people receiving personal care. The registered person said, “Most staff start on the agency side of the work and when we get to know them and feel they are suited they might move to work in the units.”
We previously inspected the service in February 2014 and no breaches of regulations we inspected.
The provider’s office is in Exmouth. When we visited there was a registered manager in post, as is required. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People were supported by sufficient numbers of care workers who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed the registered manager; registered person and care workers take the time to talk with people throughout our visit at people’s homes and at the day centre. People were relaxed and appeared comfortable in their company.
There were safe and robust recruitment procedures to help ensure that people received their support from care workers of suitable character to work with vulnerable adults. Care workers had received a full induction so they had the understanding and skills to support people.
Care workers relationships with people were caring and supportive. They offered care that was kind and compassionate; they respected people’s privacy and dignity and maintained people’s independence as much as possible.
The registered manager and care workers demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Care workers had had training about the Mental Capacity Act (2005). They understood the need to consider people's capacity to make decisions. Where there was a concern about a person's ability to make a decision, care workers described how they would work with the person, their family and health and social care professionals to decide what was in the person's best interests.
Policies and procedures were in place to ensure people were protected from the risk of abuse and avoidable harm. Care workers had received a range of training and information including safeguarding adults and they were confident they knew how to recognise and report potential abuse. People and relatives told us they felt the service was safe.
Care workers received a range of face to face training and regular support to keep their skills up to date in order to support people appropriately. Some care workers were working towards a higher qualification in health and social care.
Care workers spoke positively about the registered provider and registered manager, the teamwork and the open culture at the service.
Care records contained risk assessments and support plans which were regularly reviewed and also updated when a new concern arose. Risk assessments took into account people's ability and focussed on how to manage the risks in a positive way. People were supported to receive their medicines safely by care workers who had been trained to administer medicines. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment they required.
The provider had a range of monitoring systems in place to ensure the service ran smoothly and to identify where improvements were needed. People were encouraged to speak out and raise concerns, complaints or suggestions.