Background to this inspection
Updated
22 September 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 was announced and carried out by one adult social care inspector.
We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
Prior to the inspection we asked the local authority if they had any concerns about the service. They did not raise any issues.
During the inspection we visited two people in their own homes, spoke with one person’s relative and spoke to two people over the phone regarding the care they received. We looked at the care records for three people using the service. We spoke with three members of staff and the registered provider. We looked at the recruitment records for three members of staff. We looked at quality monitoring processes, the electronic monitoring system and other records relating to the day to-day-running of the service.
Updated
22 September 2018
This inspection was announced and took place on the 22 and 23 August 2018.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection there were 33 people being supported.
The registered manager of the service was also the registered provider. They had been registered with the CQC for a number of years. 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.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question, well led to at least good. This was because we identified a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to relevant information not being recorded in relation to the authentication of references, staff training and people’s care records. At this inspection we found that the necessary improvements had been made.
Audit systems were in place to monitor the quality of the service being provided. These consisted of spot checks, reviews of people’s care and surveys. Where improvements were required action had been taken to address these.
People informed us that they usually received care and support from the same staff and that they turned up on time. The registered provider had an electronic monitoring system that required staff to log in and out when they attended a call. Where staff did not attend on time or missed a call, office staff followed up on this to identify the reasons why.
People each had a personalised care record in place. These contained relevant information regarding people’s likes, dislikes, the level of support they required from staff and any important details relating their physical and mental health needs. These had been reviewed to ensure information stayed up-to-date. This ensured staff had access to relevant and up-to-date information.
Risk assessments were in place which assessed risk factors posed by people’s needs and any action that needed to be taken to mitigate these risks. This included risks relating to people’s skin integrity and their risk of falls. Where people had been deemed to be at risk, appropriate action had been taken to address this.
People were protected from the risk of abuse. Staff had completed training in safeguarding vulnerable adults and they had a good knowledge of how to identify and report any concerns they may have.
Recruitment processes were safe and ensure people were supported by staff who were of suitable character. Staff had been required to provide two references, one of which was from their most recent employer. They had also been subject to a check by the Disclosure and Barring Service (DBS) to ensure they were not barred from working with vulnerable groups of people.
Positive relationships had been developed between people and staff who used the service. People spoke highly of staff telling us that they were kind, respectful and treated them with dignity.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.