Background to this inspection
Updated
6 June 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: This inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type: Ambito Community Services Cornwall is a domiciliary care service. Staff deliver personal care support to people living in their own homes and support people to access community services. The service is registered to provide services to both children and adults in the following groups, Learning disabilities, autistic spectrum disorder, Older People, Physical Disability, Sensory Impairment and Younger Adults
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary service and the manager may not be available. We needed to be sure that they would be available to speak with us. We also needed to ensure that people’s consent was gained for us to contact them for feedback about the service.
The inspection took place between 29 April and ended on 30 April. We visited the office location on 29 April to see the manager and office staff; and to review care records and policies and procedures.
What we did: The provider had not received the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about.
We looked at the care and medicine records of three people who used the service. We also examined records in relation to the management of the service including four staff recruitment files, quality assurance checks, staff training and supervision records, safeguarding information and accidents and incident information.
During the inspection we spoke with the registered manager and two team leaders. We spoke with a member of support staff and a someone who used the service. Following the inspection, we spoke with two people using the service and five family carers. We also spoke with five support staff.
Updated
6 June 2019
About the service: Ambito Community Service Cornwall provides care and support to children, adults and families living in their own homes with a range of physical and learning disabilities. The service’s office is based in a community centre in Mevagissy. Packages of care and support ranged from a few hours to twenty-four-hour packages. The service was supporting seventeen people who needed support with personal care who were using the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People’s experience of using this service: Reduced staffing levels had resulted in some calls being missed or cancelled by the service.
There was no formal call monitoring system which would support the service to monitor and manage calls more effectively. We have made a recommendation about this.
Staff were recruited in a safe way. There was a recruitment programme taking place at the time of inspection to extend the staff team.
Some people did not feel confident in how the service responded to concerns. We have asked the service to consider and improve this.
People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop positive, meaningful relationships with people.
Systems were in place to protect people from the risk of abuse.
Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.
People received their medicines safely.
Staff liaised with other health care professionals to ensure people's safety and meet their health needs.
Staff were respectful of the fact they were working in people's homes.
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 supported this practice. Some people had ‘Best interest’ decisions in place to keep them safe. This had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005).
The registered manager and management team used a variety of methods to assess and monitor the quality of the service. These included staff meetings, spot checks, auditing of the service and surveys to seek people’s views about the service provided.
Why we inspected: This was the first planned inspection since the change of registration in 2018.
We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to staffing and good governance. Details of action we have asked the provider to take can be found at the end of this report.
Follow up: We will ask the registered manager to provide an action plan outlining how they will make the necessary improvements. We will continue to monitor the service and will re-inspect in line with our inspection programme.