This announced inspection took place on 11 and 15 June 2018. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure someone would be available to speak with us. This was the first inspection since the service registered with the Care Quality Commission on 9 February 2017.Head Office provides a domiciliary care service for older people living in their own homes in the community. The service offers support to people who require help with day to day care including personal care and meal preparation. At the time of our inspection there were three people using the service who were receiving personal care.
The service is required to have a registered manager and there was one in post who was also a director of the company. 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.
Staff recruitment procedures were not always followed to ensure only suitable staff were employed by the service. Auditing and monitoring processes were not robust so shortfalls were not always being identified and addressed in a timely way.
Staff undertook training, however the timeliness of some training was not always appropriate to ensure staff completed the training as part of the induction process.
People and relatives said they felt people were being cared for safely. Staff understood safeguarding procedures and were clear to report any concerns. Risk assessments for risks to people and for their home environment were carried out to maintain people’s safety. Staff understood infection control procedures and followed them. Incidents and any other events were reviewed and learned from so action could be taken to minimise the risk of recurrence.
People were assessed so their needs were identified and care and support could be planned to meet them. People and relatives were happy as they felt that staff had the skills and knowledge to care for people effectively.
Staff assisted people with simple meal preparation where required. If people were unwell, staff were clear to seek medical help including calling the emergency service if required.
Processes were in place for assessing people’s capacity to make decisions for themselves and staff understood the importance of people making choices about their care and treatment and reporting any concerns that could arise around a person’s deteriorating mental health.
People and relatives said staff were very caring and treated people with dignity and respect, taking time with people and making them feel well cared for and listened to. People were encouraged to maintain their independence and staff understood their individual needs and wishes.
Care plans identified the care and support each person required and people and relatives confirmed staff got to know about people’s backgrounds, interests and any religious or cultural needs. There was a complaints procedure in place and people and relatives confirmed they would feel confident to raise any concerns with the registered manager.
People and relatives were very happy with the service and felt that communication was good and their opinions were listened to. Staff said they enjoyed working for the service and felt well supported by the managers and directors. Policies and procedures were in place and reflected current good practice guidance and legislation.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to fit and proper persons employed and good governance. You can see what action we told the provider to take at the back of the full version of the report.