Support at Home Ltd

Support at Home is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection 75 people were receiving care.

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 they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were well protected from the risk of abuse or neglect and told us the service helped them to feel safe. Staff had completed training in adult safeguarding and were aware of their responsibilities to report any concerns. Risk was assessed as part of the management of the service and effective measures had been taken to reduce risk and maintain people’s independence. Safe recruitment practices were used to ensure that new staff were suited to working with vulnerable people. Appropriate checks were completed before new staff started work. There were a small number of minor medicines’ errors in the previous 12 months. Each error had been reported and addressed in accordance with best-practice. Staff recorded incidents and accidents in sufficient detail to aid analysis and reduce risk. Senior staff provided examples where they had used information effectively to improve practice.

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; the policies and systems in the service supported this practice. People were supported to maintain a healthy diet in accordance with their needs and preferences. Support at Home worked well with other agencies to provide care which had a positive impact on people’s health and wellbeing. When people were unwell staff acted promptly to ensure that they received appropriate care and treatment. People were involved in discussions about their care and their outcomes were good. Staff were given an induction in accordance with recognised standards for care staff. Staff were also given regular additional training to improve their skills and knowledge. Staff told us that they felt well supported.

People and their relatives spoke very positively about the caring nature of staff. They told us that they were always treated well by staff and were consulted about their care. Staff were clear about their responsibilities in relation to equality and diversity and supported people appropriately. People were encouraged to comment on the provision of care and were actively involved in the decision-making process through discussions with staff and regular meetings. Important decisions were recorded in care records and reviewed. Staff explained how they supported people with their personal care needs in a discrete and sensitive manner.

We saw evidence that people’s individual needs and preferences were consistently considered as part of the care planning process. We also saw that needs and preferences were reflected in the way care was provided. Staff understood the need for effective communication and met the requirements of the Accessible Information Standard (AIS). Important information was made available in a range of accessible formats to help people understand and to promote their involvement. Support at Home was primarily commissioned to provide personal care. However, we saw numerous examples of staff supporting people to engage in a meaningful and appropriate activities. The service dealt with complaints in accordance with their own policy and best-practice guidance. We were told how the service had responded positively when concerns were shared. The service did not routinely support people receiving end of life care. However, people’s end of life wishes were recorded in their care files.

On the first day of the inspection the assistant care manager represented the management team in the absence of the registered manager. It was clear they understood their responsibility to submit notifications regarding important events. Each of the staff we spoke with understood their role and responsibilities. Throughout the inspection the comments and behaviours of the assistant care manager and other senior staff consistently reflected their commitment to a genuinely person-centred service. It was clear that this had resulted in positive outcomes for people. Information provided after the site visit by the registered manager and human resource manager supported this view. Staff told us that they would not hesitate to inform senior staff of a concern or error. We saw evidence errors and performance issues had been recorded, reported and addressed appropriately. The service placed continuous learning and improvement at the heart of practice. They made effective use of audits, reports and other forms of communication to monitor and improve the safety and quality of care. Additional partnerships had been developed with other services in the area to improve outcomes for people.

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 17 February 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

The service provides personal care to 48 people, in their own homes.

The service requires 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.

Support at Home had a registered manager who had been in post for several years.

The service used safe systems for recruiting new staff. These included checking references and a criminal conviction check using the Disclosure and Barring Service (DBS) for criminal records.

People told us they were happy about all the aspects of their care and support in their own homes. We found that the service was adequately staffed, with competent and trained staff members. They had an induction programme in place that included training staff to ensure they were competent in the role they were doing at the service and received on-going training. Staff told us they felt supported by the senior staff and the registered manager.

The care was person centred and individual to each person’s needs and staff and senior managers kept accurate and up to date records of the care they delivered. Staff knew how to safeguard people from abuse and report any concerns.

Risk assessments were carried out for people and where they needed help, were given support to administer their medication.

The service was monitored effectively for quality and people using the service were listened to and treated with respect and dignity. Any complaints were dealt with effectively and the outcomes were recorded.

The provider had complied with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and its associated codes of practice in the delivery of care. We found that the staff had followed the requirements and principles of the Mental Capacity Act 2005 (MCA). Staff we spoke with had an understanding of what their role was and what their obligations where in order to maintain people’s rights and were aware of the differences in the implementation of the MCA in a person’s own home.