Background to this inspection
Updated
6 September 2016
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.
The inspection visit took place on 1 August 2016 and was announced. 48 hours’ notice of the inspection visit was given because the manager is often out of the office supporting staff. We needed to be sure they would be in. The inspection team included an 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 care service.
Before the inspection visit, 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. We also reviewed the information that we held about the service to inform and plan our inspection. This included information that we had received and statutory notifications. A statutory notification contains information relating to significant events that the provider must send to us as required by law.
We spoke with 13 people who used the service and with one relative of another person. The manager was not available during our visit so we spoke with the nominated individual [A nominated individual has responsibility for supervising the way that the regulated activity is managed] and with an area manager. We also spoke with eight care staff who directly worked with people.
We looked at the care records of ten people who used the service and four staff files. We also looked at other records in relation to the running of the service. These included health and safety checks and quality audits that the provider had undertaken as well as medicines records and staff rotas.
We asked the area manager to submit documentation to us after our visit. This was in relation to the provider’s aims and objectives and the support staff received. They submitted these to us in the timescale agreed.
Updated
6 September 2016
We inspected the service on 1 August 2016 and the visit was announced. We gave notice of our inspection because we needed to be sure somebody would be available at the office.
Help at Home (Melton Mowbray) is a domiciliary care service. Care and support is provided to people in their own homes. At the time of our inspection 106 people were using the service.
At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has a 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.
People had mixed views about the running of the service and some people told us improvements could be made about the lateness of some calls they received. Staff did not always feel supported and felt pressurised to take on additional work. The area manager was taking action following this feedback to make improvements.
People and staff had opportunities to give feedback to the provider. For example, staff attended regular staff meetings where they could offer suggestions to improve the service. We saw that the provider took action where this was necessary following the feedback received.
Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to. The provider’s whistleblowing procedures required improvement to include other organisations that staff could report poor practice to should they have needed to. The area manager took action following our feedback.
The provider was regularly checking the quality of the service. For example, checks of people’s care records were taking place as well as the health and safety practices of staff.
The provider had aims and objectives for the service that were known by staff. This included promoting people’s independence and dignity. We found that the aims and objectives were not always being met. For example, people were not always told when a staff member would be late for their personal care support.
The manager was aware of their responsibilities. This included them submitting statutory notifications of significant incidents to the Care Quality Commission where appropriate.
People felt safe with the support offered from staff. Staff understood their responsibilities to support people to protect them from abuse and avoidable harm. The provider dealt with accidents and incidents appropriately however, the recording of incidents was not always thorough. Risks to people’s well-being had been assessed and regularly reviewed. For example, where people were at risk of falling, there was guidance for staff to follow to support people to remain safe.
People’s homes and equipment were regularly checked and there were plans to keep people safe during significant incidents, such as a fire.
People were largely satisfied with the availability of staff and the time spent undertaking their care calls. We found calls were made to people in line with their care plans. People had mixed views on the regularity of the same staff providing their care. We saw that the area manager was trying to improve this. Staff were checked for their suitability before starting work for the provider so that people were protected from those who should not work in the caring profession.
Where people required support to take their prescribed medicines, this was undertaken in a safe way by staff who had received regular guidance and training. Staff knew what to do should a mistake occur when assisting people with their medicines.
People were largely receiving support from staff who had the appropriate skills and knowledge. Staff received regular guidance and training relevant to their role. For example, staff received training in Parkinson’s disease.
People were being supported in line with the Mental Capacity Act (MCA) 2005. People were asked for their consent before care was given and staff understood their responsibilities to regularly consider people’s capacity to make decisions for themselves.
People chose their own food and drink and were largely satisfied with the support they received from staff members. They had support to access healthcare services when required to promote their well-being.
People received support from staff who showed kindness. Their dignity and privacy was protected when receiving personal care support. Staff knew the people they offered care to and they were supported to be as independent as they wanted to be. For example, by choosing their own clothes.
Staff knew people’s preferences and had involved people in planning their own support where possible. Where people needed additional support to make decisions or to speak up, advocacy information was available to them.
People were not always satisfied with the punctuality of staff members providing their care. The area manager was monitoring this and taking action to make improvements.
People had contributed to the planning and review of their support where they could. People had care plans that were person-centred on them as individuals and had an assessment of their care requirements when they started to use the service. However, people were not always asked for their preference for a male or female staff member to provide their care. The provider was taking action to improve this.
People knew how to make a complaint. The provider had a complaints policy in place that had been made available to people. The provider took action when a complaint had been made.