26 September 2014
During a routine inspection
Is the service safe?
The provider had a system in place to monitor the quality of the service and ensure that people received safe care.
The provider had made improvements in relation to medication since our last inspection. Detailed records of medicines administered by staff included information about prescribed creams. Body maps had been included in records to ensure that creams were applied when, where and how they were prescribed. This ensured that people had their medicines administered correctly and safely in line with the prescriber's instructions.
Improvements had been made in care records to ensure that staff had the required information about the equipment and transfer techniques necessary to support people with personal care at home. This reduced the risk of people receiving unsafe or inappropriate care because appropriate records had been kept.
An effective staff recruitment and selection procedure was in place. Appropriate references and checks had been undertaken to ensure that staff were suitable to carry out their work. New staff had appropriate induction and training to ensure they had the skills and competencies to care for people safely.
Is the service effective?
People's health and care needs were assessed with them before they received the service. Regular reviews of care plans and quality reviews had been carried out to ensure people's needs continued to be met. Care information was up to date and reflected people's current needs.
People had been involved in planning their care and had signed to confirm their agreement with the care and support provided for them. All new referrals to the service, care plans and risk assessments had been checked by the manager to ensure their accuracy.
Is the service caring?
Five people using the service and seven relatives told us that they were highly satisfied with the service. People spoke highly of staff supporting them. Comments included, "I am pleased. They are great staff. If I could I would give them an award." "The carers are lovely, they do just what you want". "The staff really care, nothing is too much trouble for them." Two people made comparisons with former care services saying there had been considerable improvements.
Is the service responsive?
A copy of the complaints procedure had been included with the care information left in people's homes. The procedure stated how complaints would be managed. We found that complaints had been recorded and investigated in line with the complaints policy of the service. Complainants were always advised in writing of the outcome of complaints. We saw instances where apologies had been made and changes had been made to improve the service.
When people's health needs had changed health professionals had been contacted. Their advice had been sought, recorded and actioned.
Is the service well-led?
The service had a quality assurance system in place and records showed that identified problems and opportunities to change things for the better had been addressed promptly. The system included listening to people who used the service, their relatives and staff. There was a pro-active approach to complaints made about the service. The provider sought the views of people and consistently reviewed the service in response to the views expressed by people.
Staff told us they were clear about their roles and responsibilities. They told us they could speak to a senior member of staff at any time including the on-call manager after hours. Regular supervision had been provided for all staff. We saw examples during our visit of good open communication between office staff and support workers who all visited the office each week. A staff member said, "We have really good support. There have been changes to staff, including office staff and the staffing is now good."