We inspected this service so we could consider our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? One inspector carried out this inspection.There were 27 people using the service for personal care at the time of our inspection. Other people were using the service for companionship or housekeeping but these services were not regulated by the commission. Following our last inspection in April 2014 we had received information of concern about the service. We inspected the service to consider the concerns that had been raised. Below is a summary of what we found. The summary is based on speaking with four people who used the service, seven relatives and six members of care staff supporting them. We also spoke with the manager of the service, two office staff, the nominated individual and two health / social care professionals.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People or their relatives confirmed that they believed that the service was safe. Their comments included: "I was unwell at the weekend they did everything that was needed and got a doctor to visit me" and "I have felt that all the care staff are trustworthy," All of the people were happy about how care staff accessed the property where they lived and received care.
Staff told us about us about their training in health and safety and the support they received from the office staff if they were worried about a person's safety. Risk assessments had been written to ensure that people were moved safely and that their health needs were met. People confirmed that a copy of these records were kept on their property for staff to look at.
There were enough staff available to ensure that people received the service that was expected. People told us that staff arrived on time, did not rush and that the aim of the service was to provide consistent care staff. Where it was known that staff were not going to be able to make planned visits, arrangements had been made for someone else to provide the care and respond and wherever possible this was someone the person had already met.
CQC monitors the operation of Deprivation of Liberty Safeguards. There had been no applications to deprive any people of their liberty at the time of our inspection.
Is the service effective?
We found that staff were trained in moving and handling of people by a member of staff that had the appropriate training qualification. We saw and were told that where relatives wanted extra records to be kept to ensure the service was delivered as required or risks minimised care staff maintained these records. People or their relatives told us that care staff knew how to use any equipment that may be needed to support people in their own homes. We talked to staff about the care people needed and found that they knew about the care needs of specific people they were supporting.
Amongst the comments we received from people, relatives and staff were: "They made a thorough assessment of my relative's needs, they provided good support and (my relative) has taken to (care staff name)," "Two of the care staff who visit (my relative) stand out in their understanding of dementia" and "I work for this service because we are not expected to rush and also you do not just get generic moving and handling training you get training specific to the individual." People received a service that was effective in providing for their needs.
Is the service caring?
People who used the service or their relatives told us they felt cared for. Their comments included: "The three care staff that are in place are very caring...they remembered my relatives birthday and took them out," "I wouldn't want to change the care staff coming into my home they are excellent," "They have been really good to me and they love my relative to bits," and "(My relative) loves the care staff, their care is spot on."
We spoke to six care staff as well as the management team and provider. All of them spoke about people in a caring way and wanted to ensure that people received the care in the way that they wanted. We spoke with three care staff in detail about the values of the service they worked for all of them told us that the service covered this in their initial training. They all told us that: they had to be polite, not to rush people's care, be 'talkative' when supporting people, be mindful that it is the person's home and to respect people's religion and culture. People received a caring service.
Is the service responsive?
People's comments included: "We have been listened to, if my relative hasn't got on with a member of care staff they have been changed," "They are conscious of my relative's good and bad days and they ring me if they have any concerns" and "We started off with a call a day but it is likely to increase." All of the people we contacted said that they could contact the office and change arrangements if they needed to. Several of the people we spoke with described the service as "Professional."
We found that there were appropriate records of complaints and that the service acted appropriately to them. We spoke with two health professionals who told us that they had worked well the service and the nominated individual.
Is the service well-led?
The service was led by a manager who had the qualifications, skills and experience to provide a good, well led service.
People or their relatives we spoke with were confident that they could speak with the office staff and management and their concerns would be listened to. Comments included: "We have been listened to, if my relative hasn't got on with a member of care staff they have been changed," "They are conscious of my relatives good and bad days and they ring me if they have any concerns" and "We started off with a call a day but this is likely to increase." A number of people we spoke with told us that the service offered good value for money.
There were systems in place to ensure that people received care from a small group of consistent care staff. Rotas were available to people receiving a service and their relatives. These rotas were only changed when care staff were not available; at which point efforts were made to ensure that the covering staff were known to the individual needing support.
People we spoke with knew the office staff, the manager, and the nominated individual of this service.
This led us to conclude that the service was well led.