Background to this inspection
Updated
2 June 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.
This inspection took place on 18 and 20 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the senior staff are often out of the office supporting staff or providing care. We needed to be sure that they would be available. The inspection was carried out by one inspector.
Prior to our inspection, we reviewed information we held about the service including the action plan supplied to us after the last inspection stating how and by when the service would improve. Before the inspection, the provider completed a 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.
Some people had complex needs, which meant they could not always readily tell us about their experiences. They communicated with us in different ways, such as facial expressions, signs and gestures. We also observed interactions between staff and individuals in communal areas. We spoke with three people using the service, two relatives, two professionals, five members of support staff plus the deputy and the divisional manager.
We reviewed five support plans, five medication administration records, three recruitment files, staff rota’s, training records and other records about the safety and quality monitoring of the service.
Updated
2 June 2018
The inspection took place on 18 and 20 April 2018 and was announced. The service is registered to provide personal care and supports people mostly with a learning disability and is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. On the days of our visit there were 28 people supported by the service.
The inspection was announced as this service is small, we wanted to make sure that someone would be available when we visited.
Following the last inspection of May 2017, we asked the service to complete an action plan to show what they would do and by when to improve upon the management of agency staff and quality assurance.
At this inspection, we found that the service had increased the staffing levels so that there were sufficient staff to support people. Agency staff were required to cover unexpected staff absences on rare occasions. The agency staff had received training and senior staff support in order that they could support people to meet their assessed needs. The quality assurance systems had been developed and information from the audits had been used to improve the service and the support provided to people in relation to their assessed needs.
A registered manager was in place and was based at the service central office. At the time of our inspection the registered manager was not working at the service. The service had made the Care Quality Commission aware of this information and during their absence the service was being managed by the divisional director and supported by other senior staff in the organisation. The divisional director is the line manager of the registered manager.
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.
Senior staff visited the people using the service and the staff they managed regularly and did provide support themselves when the need arose. People looked at ease with staff and told us that the staff were knowledgeable and caring
Each person had a support plan and a risk assessment which identified actions which should be taken to minimise the identified risk. Staff were knowledgeable about the signs of abuse, and the actions that they would take should they have any concerns.
There was a robust recruitment process and staff received an induction, supervision and on-going training. Medicines were safely stored and administered as prescribed. There were regular planned audits of medicines and people’s finances to ensure the records were in agreement with the stock of medicines and peoples personal money.
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.
Support plans were in place for each person and focussed upon how the staff would support the person to meet their needs. People were aware of their care plans and had contributed to them. The information provided staff with the information they needed to support people. People’s preferences and choices had been identified in their support plan.
People choose the food and drinks they consumed. Some people were supported by staff to go shopping so that they could select the food and drinks they wished from the shops.
There was a complaints policy and procedure in place. Relatives informed us they were confident any complaint would be listened to and investigated. All people were supported by staff to pursue activities and interests of their choice.
The service staff provided a positive culture of support to the people using the service. Service governance was in place made up of surveys, audits and management plans which were used by the senior staff to plan and deliver the support to the people using the service.