The inspection was undertaken by one inspector. We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? At the time of our inspection two people were receiving care. We spoke with relatives of both people who used the service, the manager and three members of staff.Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
We spoke to relatives of two people who used the service. They told us that they felt their relatives were safe when being supported by care staff.
People told us that care staff knew how to care for them. We spoke with care staff and looked at records. Staff were able to explain people's specific care needs. However care records were not properly organised and did not always contain information on how staff should support people who were at risk of not taking their medication to do so.
Staff received training in how to use equipment so people were kept safe from harm. Staff had not received robust safeguarding training. Staff we spoke to were unable to explain the principles of safeguarding or external agencies they could refer safeguarding concerns to. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that care staff have sufficient knowledge in order to keep people safe from the risk of harm.
Is the service effective?
Where necessary, risk assessments had been undertaken and were used to help staff provide appropriate, safe and consistent support to people who used the service.
People who used the service were asked to comment on the service provided, this included questions about the support they received.
People's health and care needs had been reviewed with them. We saw that care records were updated as people's needs changed. Care plans contained information and guidance about people's specific conditions. However, there were not always assessments about the risks of people not taking their medications. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that care records contain appropriate information for staff to meet people's care needs and how to respond to risks when people did not want their planned care and support.
Is the service caring?
All the people we spoke to confirmed that staff were kind to them. Comments included: 'The staff are very good' and 'We are happy with the service'.
When speaking with staff it was clear that they genuinely cared and knew about the people they were supporting. People's preferences, interests, aspirations and diverse needs had been recorded and support had been provided in accordance with people's wishes.
Is the service responsive?
People were supported to comment on the care they received at regular meetings. People told us that the provider made them feel comfortable to raise concerns. We saw that the provider responded appropriately to concerns so that the service could improve. A relative of a person who used the service told us, 'I don't have any concerns.'
The provider had a complaints policy which showed people how to make a complaint if they were unhappy. The manager was aware of the provider's policy and knew how to respond to concerns. People told us that they had copies of the provider's complaints policy in their homes but had not needed to raise a complaint.
Is the service well-led?
The provider regularly sought the views of the people who used the service. We saw evidence that they had introduced changes to how people were supported in response to comments received. A person told us, 'They [the manager] are pleasant and approachable.'
There was evidence that the provider had ensured that learning from incidents took place and appropriate changes were introduced or implemented to keep the people safe from harm. We saw that the provider had reviewed their staffing rota in response to concerns. But the provider had not responded to all the concerns we raised at a previous inspection.
The manager and staff told us they did not hold meetings or supervisions with staff to discuss quality issues to ensure that people received a good quality service at all times.
The provider conducted spot checks to assess the quality of the care being delivered in people's homes however these were ad-hoc. The service did not have a robust quality assurance system to review the quality of the service. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that they regularly assess and monitor the service in order to protect people against the risk of inappropriate or unsafe care and treatment.