Archived: Blackburn with Darwen Borough Council Domiciliary Care

At our last inspection, we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Records showed that staff had been recruited safely. The staff we spoke with were aware of how to safeguard adults at risk. There were safe processes and practices in place for the management and administration of medicines.

People were supported by a number of different reablement support workers due to the short term nature of the service provided. People told us they were happy with the staff who supported them.

Staff received an effective induction and appropriate training. People supported and their relatives felt that staff had the knowledge and skills to meet people’s needs.

People received appropriate support with eating, drinking and their healthcare needs. Referrals were made to community health and social care professionals when appropriate, to meet people’s needs and manage their risks.

People told us staff respected their right to privacy and dignity. They told us staff took their time when providing support and encouraged them to be as independent as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. Where people lacked the capacity to make decisions about their care, the service had taken appropriate action in line with the Mental Capacity Act 2005.

We saw evidence that people received care that reflected their needs, risks and preferences. People told us they had been involved in discussions about their care and we found that where appropriate, their relatives had been consulted.

The service had a registered manager in post. Relatives and staff told us they were happy with how the service was being managed. They found the registered manager, deputy managers and staff approachable and helpful.

The registered manager sought regular feedback from people being supported, relatives and staff about the care support provided. A high level of satisfaction had been expressed about most areas of the service. Where improvements had been suggested, we found evidence that action had been taken to address these.

Audits of many aspects of the service had been completed regularly. We found the audits completed were effective in ensuring that appropriate levels of quality and safety were maintained at the service.

Further information is in the detailed findings below.

Was the service safe?

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, safeguarding, whistleblowing and investigations. The manager audited any incidents and used the information to improve the service.

We spoke with three people who used the service who told us, "I feel very safe using the service", "The staff are trustworthy and you get to know them well. They leave my property secure" and "I feel safe with the staff and think they are trustworthy. Safer than the hospital where I had money stolen".

The service had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one.

Was the service effective?

People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. We looked at three plans of care and found them to be individual to people's needs and kept up to date. Three people who used the service told us, "They have helped me a lot. The care has been good", "The care staff always ask me what I want and what help I need" and "The service is smashing. They are reliable and turn up when they are supposed to".

Specialist dietary, mobility, skin care and community support needs had been identified in care plans where required. Specialist equipment was provided such as pressure relieving devices or mobility aids. People had access to healthcare professionals and specialists for treatment and advice.

The manager and other key staff audited the effectiveness of the systems they used. This included medication, the environment, infection control and plans of care. The information was used to improve the service.

There were effective systems for infection control and staff were provided with the equipment necessary to protect their health and the health and welfare of people who used the service.

Staff were trained in key topics such as health and safety, infection control, fire awareness, food hygiene, medication administration, first aid, mental capacity, deprivation of liberties and moving and handling. There were other training opportunities in dementia care. Staff were encouraged to take a nationally recognised qualification in health and social care. A staff member said, "We get enough training to do the job. We have regular supervision, appraisal and spot checks. The managers are good and very supportive. If we have a problem they will support us and I feel confident that I can get hold of managers if I need them. I like working for this organisation".

Was the service caring?

People were supported by kind and attentive staff. A relative said, "It is a good system and fantastic service. They explained what they provided and helped us overcome our problems. I am very happy with the service". Three people who used the service said, "They treat me very privately and all the staff I have met have been really nice", "The girls are all brilliant. I have no complaints" and "The staff are lovely".

Was the service responsive?

The regular reviews of people's care ensured their goals were being met or further support was provided. One person who used the service told us, "I asked to be put to bed earlier than I first agreed to. They improved the care for me. They check up on me and listened to what I wanted".

The registered manager held regular meetings with people who used the service and staff. Staff were able to voice their opinions at meetings and supervision sessions.

Was the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. There was a system for providing information to other providers in an emergency.

Records we looked at were up to date and policies and procedures had been reviewed by the manager. The records were stored securely and readily available for inspection.

The service had good quality assurance systems. The registered manager undertook regular audits of the service. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually improving. We looked at the positive results of the questionnaires and some of the comments included, "All aspects of the service are very good", "Well satisfied with the service I received and all the girls made me feel at ease", "I can't think of any improvements to the service which helped me get back my independence", "An excellent service, the women who helped me bathe were so discreet and dignified" and "I was happy with the service from day one. I was happy with everything. It is a wonderful service".

Two staff member who worked at the service told us, "I like working here. You can see the improvements people make to reach independence" and "I think it is a great place to work. What we do improves peoples' lives but it also releases the pressure on families". Staff also told us they were well trained and given good support by management. There was a well motivated staff team to meet the needs of people who used the service.

Plans of care were detailed and were regularly reviewed to enable staff to deliver effective care.