Background to this inspection
Updated
8 March 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 13 December 2017 and was announced. We gave the service 24 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
We visited the office location on 13 December 2017 to see the manager and office staff; and to review care records, policies and procedures.
The inspection was carried out by one adult social care inspector and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience telephoned people who use the service and their relatives following the inspection.
Before our inspection, we looked at information the Care Quality Commission (CQC) had received about the service including notifications received from the registered manager. We checked that we had received these in a timely manner. We also looked at safeguarding referrals, complaints and any other information from members of the public. We also checked with the local authority quality assurance team and the local Healthwatch organisation to see if they had any concerns or information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During the inspection we spoke with four people who received support in their own homes, four relatives and three staff. We reviewed a range of documentation including six care plans, risk assessments, medication records, records for five staff, staff training records, policies and procedures, auditing records, health and safety records and other records relating to how the service is managed.
Updated
8 March 2018
This comprehensive inspection took place on 13 December 2017 and was unannounced.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of inspection Sylvan Home Care Services were providing care to 53 people living in the community. The service employed 24 staff including the registered manager who had been in post since September 2014.
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.
People we spoke with told us they felt safe receiving support and people’s relatives also told us they felt people were safe. During our visit, however we identified concerns with the service. The service had previously been rated as Good.
We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. However we found that some new staff did not have two references prior to employment and previous work histories had not been fully disclosed as was stated in the services policies. We saw that some risk assessments for people in need of moving and handling were not in place and that topical medications (creams) were being applied by staff without the management knowledge. This had been logged in daily record sheets that had not been fully checked by the manager.
The people and the relatives we spoke with had no complaints about the service. The provider had a complaints procedure in place and this was available in the ‘service user guide’. However it was unclear what the service classed as complaints.
The registered provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults. Staff received a comprehensive induction programme and had regular training to enable them to work safely and effectively.
People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. The service had quality assurance processes in place including audits, staff meetings and quality questionnaires. The services policies and procedures had been regularly reviewed by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing, safeguarding and recruitment.
We found that people and their relatives were involved in decisions about their care and support. The care records we looked at contained good information about the support people required and recognised people’s needs. People told us they were happy with the staff and felt that the staff understood the support needs of the people using the service. People confirmed that staff stayed for the length of time allocated and arrived on time.
Staff received a comprehensive induction programme and had regular training to enable them to work safely and effectively. Staff had been regularly supervised and appraised. Staff had access to gloves and aprons and had received training about health and safety and food hygiene. This meant the infection control standards of the service were of a good standard.