This inspection took place on 22 May 2017. We gave the service 48 hours’ notice of the inspection because it is a domiciliary service and the manager is often out of the office supporting staff. We needed to be sure that they would be in.Delta Care Ltd – Chorley is a privately owned domiciliary care agency. They are situated in Chorley near the town centre. The agency provides care staff to support people in their own homes. They provide assistance with tasks such as personal care, food preparation, medication administration and household chores. The service supports people around Chorley, South Ribble and surrounding areas. Services are provided to older adults, adults with physical disabilities, adults with memory loss or living with dementia, adults with complex needs and adults with specific conditions such as substance misuse problems. At the time of our inspection the service supported 84 people and employed 26 care staff.
The service had a registered manager in post. 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.
This inspection was the first inspection since the service was registered with the Commission on 19 April 2016. During this inspection we found the service was meeting the requirements of the current legislation.
We looked at how the service protected people against bullying, harassment, avoidable harm and abuse. We found there were policies and procedures on safeguarding people. Staff had received up to date training in safeguarding adults and they showed awareness of signs of abuse and what actions to take if they witnessed someone being ill-treated.
Safeguarding incidents had been investigated and documented, showing the support people were getting after incidents. Staff had sought advice from other health and social care professionals where necessary. There were risk assessments which had been undertaken. Plans to minimise or remove risks had been drawn and reviewed in line with the organisation’s policy. These were robust and covered specific risks around people’s care in a person centred manner.
Lone working and environmental risk assessments were in place to ensure the safety of care staff and people they support. During the inspection we observed staff were visiting people at the planned and agreed times. However we found systems for checking whether staff had visited as planned had not been effectively implemented and monitored.
There was a medicines policy in place and staff had been trained to safely support people with their medicines.
We looked at recruitment processes and found the service had recruitment policies and procedures in place to help ensure safety in the recruitment of staff. These had been followed to ensure staff were recruited safely for the protection and wellbeing of people who used the service.
Records we saw and conversations with staff showed the service had adequate care staff to ensure that people's needs were sufficiently met.
We found care planning was done in line with the Mental Capacity Act, 2005. Staff showed awareness of the Mental Capacity Act, 2005 and how to support people who lacked capacity to make particular decisions. They had received mental capacity training.
Majority of the feedback from people about care staff was positive. However; we received mixed views regarding some care staff and the organisation although a significant amount of people told us their experiences had been positive.
People using the service had access to healthcare professionals as required to meet their needs. Staff had received training deemed necessary for their role. Staff competences were checked regularly in various areas of practice including moving and handling, medicine administration and food hygiene. Staff had received supervision through spot checks and supervision meetings at the office. They had also been provided with annual appraisals.
We found that people’s care needs were discussed with care commissioners before they started using the service to ensure the service was able to meet their assessed needs. Care plans showed how people and their relatives were involved in discussion around their care. People were encouraged to share their opinions on the quality of care and service being provided. People’s nutritional needs were met. Where people's health and well-being were at risk, relevant health care advice had been sought so that people received the treatment and support they needed.
There were established management systems at the service. Senior management had been involved in the day to day management of the service. The registered manager had provided oversight duties they delegated to other staff.
Quality assurance systems were in place and various areas of people’s care been audited regularly to identify areas that needed improvement. We found audits had been undertaken of care records, and medicine administration records. There was a business contingency plan to demonstrate how the provider had planned for unexpected eventualities which may have an impact on the delivery of regulated activities.
Surveys we saw showed people felt they received a good service and spoke highly of their staff. Relatives told us the staff were kind, caring and respectful. Professionals we spoke to confirmed this.
We found the service had a policy on how people could raise complaints about their care and treatment.