9, 10 April 2014
During a routine inspection
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.
Is the service caring?
We saw that people were supported by kind and attentive staff who displayed patience and gave encouragement when supporting people. Our observations confirmed that staff promoted independence whilst ensuring that they offered assistance to people when required. People told us that they were happy with the care and support they received from the service. One person said, "It's really good, they support us with the things we need" and "It's brilliant."
People told us they pursued many activities and this was evident on the day of our visit. Some people were supported with work placements and to attend social events. This showed that the provider promoted people's community involvement and well-being.
The provider promoted people's independence as much as possible. People told us that they felt respected and their privacy and dignity was maintained at all times by staff.
Is the service responsive?
People's care needs were assessed before they received a care service from the provider. Records showed that keyworkers had regular meetings with the people they cared for to discuss what was important to them and any goals and aspirations they may have. The provider reviewed people's care records regularly and made amendments to documentation as people's needs changed, to ensure they remained accurate and any issues were promptly addressed
Staff told us, and records showed that where people required input into their care from external healthcare professionals, such as psychiatrists, they were supported by staff to arrange this as independently as possible and to attend scheduled appointments.
People told us they felt included in decisions made about their care and they made choices in all aspects of their lives. This was supported by our findings when we spoke with people's relatives and staff. Documentation showed the provider gave people information about their care choices and about the service they should expect to receive. This showed the provider was inclusive and responded to people's preferences.
There was an effective complaints system in place and when we reviewed complaints that had been received in the service, we could see that these had been handled thoroughly.
Is the service safe?
People were supported by staff to live in safe, clean and hygienic environments within their own homes. There were enough staff on duty to meet people's needs and a member of the management team was available on call for support and in the event of an emergency. Records showed that staff were appropriately trained to ensure that they were equipped with the correct skills and attributes to carry out their jobs effectively and safely. Documentary evidence showed that people were encouraged and supported to carry out health and safety checks within their homes regularly to ensure that they remained safe within their environments.
People's care needs had been assessed and their care records showed that risk assessments were in place to reduce the chances of them coming to any harm, whilst living their lives as independently and fully as possible. For example, we saw that where people were at risk of injury whilst bathing, this was clearly highlighted in their care plans and risk assessments. Where relevant, the provider had drafted a personal emergency evacuation plan (PEEP) for people, to ensure that staff had instruction on how to evacuate them from their homes, should this be necessary, for example, in the event of a fire or a flood.
We reviewed the safeguarding policy and procedures in place to address and manage incidences of a safeguarding nature. We found that these arrangements were both appropriate and safe. Records showed that staff were trained in safeguarding awareness within the last year. Staff and management were able to give us examples of different types of harm and abuse, and they confirmed how they would report and progress any safeguarding matters brought to their attention.
Is the service effective?
People told us they were happy with the staff who cared for them and they met their needs. One person said, "I am happy with everything. This is the best support network that I have had." Another person told us, "The staff are very excellent." It was clear from speaking with staff and our observations that staff had a good understanding of the people they cared for and their needs.
Certificates were available that showed staff had received appropriate and up to date training to meet people's needs effectively.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. The results of a recent survey undertaken as part of the provider's quality assurance system showed that an external agency had commented, 'Staff are good at liaising with care managers and community support workers'.
An effective quality assurance system was in place which was successful in identifying shortfalls. Records showed that these shortfalls were promptly addressed. We saw the provider learned from accidents and incidents and in each case these were reviewed. The provider had introduced measures to prevent repeat events, wherever possible.
Staff told us they were clear about their roles and responsibilities. The provider had a range of policies and procedures in place which gave direction and instruction to staff. We saw staff meetings were held on a regularly basis and minutes showed that management and staff discussed people's needs and the service provided overall. This helped to ensure that people received a good quality service at all times.