Background to this inspection
Updated
23 October 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was undertaken by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they 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. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 8 October 2019 and ended on 10 October 2019. We visited the office location on 8 and 10 October 2019.
What we did before inspection
We reviewed all the information we held about the service. We contacted relevant agencies such as the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with four relatives of people who used the service. We did not speak with people who used the service as they were not able to communicate their views or did not wish to speak with us. We also spoke with one member of staff, the registered manager and the nominated individual, both of whom provide care and support to people as part of the staff team. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed four people's care records, policies and procedures, records relating to the management of the service, including recruitment records, training records and quality audits.
After the inspection
We continued to seek clarification from the registered manager and nominated individual to validate evidence found. We looked at key documents and quality assurance records.
Updated
23 October 2019
About the service
Page Alliance Healthcare Limited is a domiciliary care agency providing personal care and support to people in their own homes. It provides a service to older people and younger adults. At the time of inspection, the service was providing personal care to five people.
People's experience of using this service and what we found
Overall, medicines were managed safely. Action was taken at the time of the inspection to improve medicines records. People’s relatives were very positive about the service and the care and support their family members received. They said the care and support provided was safe. Risks associated with care and the environment were recorded and monitored. There were enough staff to meet people’s needs in a consistent and flexible way. Staff protected people from avoidable harm, were knowledgeable about safeguarding and felt able to raise concerns. Systems were in place to recruit staff safely.
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. Consent to care was sought and recorded; staff understood people’s rights to make their own decisions. Staff received appropriate training and support to enable them to carry out their roles effectively and safely. New staff received an induction and shadowed the management team as part of this. Systems were in
place to ensure information to support people was shared and discussed appropriately with health professionals, where necessary.
People’s needs were assessed before they began to use the service and care plans were developed from this information. Care plans overall, contained information for staff to support people according to their needs. Some care plans needed strengthening to ensure they contained more detail about people's care. Action was taken to address this at the inspection. People told us staff were caring, treated them well and respected their privacy and dignity. Staff were described as very kind and patient. Care plans showed people had been involved in their care planning and in regular reviews. Staff promoted people’s independence and knew people's needs well.
The provider had a system in place for responding to people's concerns and complaints. People’s relatives told us they felt confident to raise any concerns. Staff were aware of people’s rights to make complaints. Procedures were in place to learn from incidents and actions taken to improve the service were recorded. People were treated with compassion. People who required palliative care were supported by staff with experience of this to ensure personalised end of life care.
People thought the service was well led. The registered manager and nominated individual were clear about their vision for the service, and ensured they shared this with the staff team. There was an honest and open culture; regular discussions with people, relatives and staff took place. Compliments and surveys showed people were happy with the service they received. Quality assurance systems were effective and identified where the service needed to improve. The registered manager and nominated individual were responsive to any issues raised during the inspection and demonstrated a passion and enthusiasm for driving improvements in the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection This service was registered with us on 26 October 2018 and this is the first inspection.
Why we inspected
This was a planned inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.