13 January 2016
During a routine inspection
This comprehensive inspection was carried out on 13 January and 4 February 2016. We gave the provider 48 hours’ notice of the inspection as we needed to be sure that a senior member of staff would be available.
This service requires a registered manager. 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. There was no registered manager in place. The previous registered manager left the service in late 2015, following a period of absence. The member of staff managing the service at the time of the inspection (referred to throughout this report as the manager) had worked at the service for a number of years. They had been the deputy manager before being appointed to the post of manager in January 2016.
People and their relatives told us they were very happy with the service being provided by the agency. They were complimentary about the staff and about the management of the service. People, relatives and staff made a special point of praising the manager who was newly appointed to the post.
We saw that people receiving a service and the staff got on well together and were comfortable in each other’s company. People told us they felt safe with the service provided and relatives had no concerns about the safety of their family members. Staff had undergone training and were competent to recognise and report any incidents of harm. Potential risks to people were assessed, recorded and managed so that people were kept as safe as possible.
Staff had been recruited in a way that ensured as far as possible that they were suitable to work in a care environment. There were a sufficient number of staff on duty to meet people’s assessed needs and support them in the way they wanted to be supported. Staff had undertaken a range of training courses so that they were equipped to do their job well. Medicines were managed within good practice guidelines.
The Care Quality Commission (CQC) is required by law to monitor and report on the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. Most of the people who received a service from the agency had mental capacity to make their own decisions. Staff showed that they respected people’s choices and supported each person in the way they preferred. However, not all staff were able to demonstrate a sufficiently robust understanding of the MCA and DoLS. This increased the risk that decisions made on behalf of people who did not have capacity might not be in their best interests and as least restrictive as possible.
Staff supported people to have sufficient amounts of food and drink to meet their nutritional needs. Staff also supported people, when required, to access health care so that their health and well-being were maintained.
Staff showed that they cared about the people they were looking after. Staff treated people with kindness, respect and compassion and made sure that people’s privacy and dignity were upheld at all times. People’s personal information was kept securely so that their confidentiality and privacy were maintained.
People, and their relatives when appropriate, were involved in planning the care the person needed. Staff gathered as much information as possible about the person so that the person received the care they needed in the way they preferred. Care plans were personalised and showed that staff supported people to be as independent as possible.
The provider had a complaints procedure in place. This had not always given people the information they needed to be able to raise their concerns effectively. The manager was in the process of updating the information so that people would have external contacts to whom they could complain.
People and their relatives were encouraged to put forward their views about the service in both formal and informal ways. Staff were also given opportunities to put forward their ideas about ways in which the service could improve. Audits of the service were carried out to make sure that the best possible service was provided. Records were maintained as required.