Background to this inspection
Updated
13 January 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 was planned to check 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.
The inspection took place on the 06, 07 and 08 November 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care to people in their own homes and we needed to be sure that someone would be available to meet with us. The inspection team consisted of one inspector and an expert by experience. An expert by experience is someone who has had experience of working with this type of service.
As part of the inspection process we looked at information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any incidences that put people at risk of harm. We refer to these as notifications. We checked if the provider had sent us notifications in order to plan the areas we wanted to focus on during our inspection. The provider had sent us a Provider Information Return (PIR) before the inspection. A PIR is a form that asks the provider to give key information about the home, what the service does well and improvements they plan to make. We reviewed regular quality reports sent to us by the local authority to see what information they held about the service. These are reports that tell us if the local authority commissioners have concerns about the service they purchase on behalf of people. We also contacted the local authority for information they held about the service and reviewed the Healthwatch website, which provides information on health and social care providers. This helped us to plan the inspection.
We spoke with three people that used the service, four relatives, the nominated person, four care staff and the care co-ordinator. We looked at four people’s care records to see how their care and treatment was planned and delivered. Other records looked at included four staff recruitment files to check suitable staff members were recruited. The provider’s training records were looked at to check staff was appropriately trained and supported to deliver care to meet people’s individual needs. We also looked at records relating to the management of the service along with a selection of the provider’s policies and procedures, to ensure people received a good quality service.
Updated
13 January 2018
This inspection took place on 06, 07 and 08 November 2017 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care to people living in their own homes and we wanted to make sure staff would be available. At the last inspection on 18 February 2016, we found that the provider was ‘good’ under the key questions of safe, effective, caring and responsive and required improvement under the well-led.
Firstpoint Homecare Limited is a domiciliary care agency registered to provide personal care to people living in their own homes. Firstpoint Homecare Limited also provides support to people on a daily basis that includes staff living with the person in their own home. The support is provided by means of set hours. For example nine till five each day and then another member of staff would remain overnight to support the person. At the time of the inspection the service supported 39 people ranging in age, gender, ethnicity and disability.
There was a registered manager in post at the time of the inspection. 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 felt supported and spoke highly of the management team and felt involved in developing the service. The provider had quality assurance and audit systems in place to monitor the care and support people received. Although not all the systems were effective and required improvement.
People felt they were safe and their homes left secured after staff had completed their visits. Relatives believed their family members were kept safe. Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. Risks to people were assessed and monitored and people were supported by staff that was provided with guidance on how to manage people’s specific medical conditions. The provider had processes and systems in place that kept people safe and protected them from the risk of harm.
People were supported by sufficient numbers of staff that had been safely recruited although their recruitment processes required some improvement. People were supported with their medication by staff that had received appropriate training. Staff were equipped with sufficient personal protection equipment to reduce the risk of infection and cross contamination when supporting people with their personal care.
People’s needs were assessed by a qualified nurse to ensure the care and treatment provided was individual to the person. People were supported by staff that felt they had the skills and knowledge to care and support people in their homes. Where appropriate, people were supported by staff to access health and social care professionals; with timely referrals made to healthcare services when people’s needs changed.
People were supported to make choices and involved in the care and support they received. The provider was taking the appropriate action to protect people’s rights.
People told us staff members were caring and treated them with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs. People were supported with their healthcare needs and felt involved with their care provision.
People felt they could speak with the provider about their worries or concerns and most felt they would be listened to and have their concerns addressed.
People felt reassured the provider would ensure their personal preferences and choices were respected at the end of their life to ensure a comfortable, dignified and pain free death.