Background to this inspection
Updated
22 May 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by one inspector and an 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and seven relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, assistant manager and care workers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who had regular contact with the service.
Updated
22 May 2021
About the service
Firstpoint Homecare – Harpenden is a domiciliary care service providing personal care to older people and younger adults who may live with dementia, sensory impairments or physical impairments. At the time of the inspection 38 people were using the service.
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 felt safe with the care they received, and staff were knowledgeable about when to report concerns to safeguard people. Risk assessments highlighted people's individual needs, and professionals were referred to when staff needed input for people. Where things went wrong, this was shared with staff and lessons were learnt and changes implemented.
Medicines were given to people when they needed them, where discrepancies were identified these were actioned appropriately. Infection prevention control measures were in place and staff were wearing appropriate personal protective equipment (PPE).
People felt they were able to express how they wanted to be supported and staff were skilled and knowledgeable about their role. The provider ensured that staff went through a recruitment process and all relevant employment checks were completed.
People and relatives felt staff were kind and people were happy with the support they received. One relative said, “They are good, gentle and kind. They maintain her dignity at all times. The carers have been her family.” People had the opportunity to shape the support they received through giving feedback. People were supported to talk about decisions about their preference for their support, in addition if they wanted to speak about end of life care.
There were enough staff to support people at the time of the inspection. The service had a change in management since the last inspection, the overall feedback was positive. The registered manager had systems in place to manage complaints. Overall, people and relatives said they felt listened to when they raise any concerns.
People gave mixed views about the communication between them and the management team. The management team acknowledged this and were putting additional communications in place such as a newsletter for people.
The registered manager had implemented a lot of changes since the last inspection which had been acknowledged by the staff team. Systems had started to be used in a robust way and there were clear outcomes from the quality assurance systems in place. However, at the time of the inspection these changes had only recently been implemented. The registered manager understood the need to ensure the quality of care continued, and to ensure the systems and culture of the service is sustained.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 12 March 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.