Background to this inspection
Updated
23 June 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.
This inspection took place on 21 and 25 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
There were two inspectors on the first day and one inspector on the second day. Before the visit to the registered address, we reviewed information held by us on the provider. This included details of statutory notifications, which are details of incidents that the provider is required to send to us by law. We also spoke with the local social services and commissioning teams and reviewed information available from the local Healthwatch organisation.
During the inspection, we visited the registered location and two residences where people lived. We spoke to three people who used the service, four members of staff, the assistant manager and two service managers. We also spoke with two relatives of people who used the service and one health care professional on the telephone after the visit. We undertook observations of staff interaction with people who used the service during the inspection.
We looked at records held by the provider including; the care records of four people who used the service and the medicine and money management processes. We also looked at records about complaints, incident reporting, staffing, training and audits looking at the quality of the service.
Updated
23 June 2016
This inspection took place on 21 and 25 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The previous inspection took place in June 2014 when the provider was compliant with the CQC regulations it was inspected against.
People in Action is registered to provide domiciliary and supported living services to children 0-18, younger adults and older people who may have mental ill-health, dementia, sensory Impairment, physical disability or learning disabilities or autistic spectrum disorder. The regulated activity is for persons who require personal care. At the time of inspection, there were five people who received this activity from the provider. During the inspection, we visited some people in their homes to talk to them.
There was a registered manager in post. 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 we spoke with felt safe and happy and felt they could approach staff for support. People looked relaxed and comfortable in the presence of staff. Relatives told us that they were confident that staff protected and kept their relative safe.
Support staff had the training and knowledge in protecting people from abuse. People had appropriate risk management plans. However, some staff did not always follow health management plans concerning people’s physical health.
People’s support needs were assessed and suitable staff numbers were arranged. People were supported by staff that were recruited following appropriate checks and had received the relevant training. We saw through people’s engagement with staff, that they were happy and got on well with the staff.
People received their medicines safely and as prescribed to them.
The provider had systems in place to review people’s support plans. Both people who used the service and their relatives were involved in writing and updating peoples’ support plans.
Staff told us that they obtained consent from people and where appropriate relatives who held the responsibility to make decisions on people’s behalf.
People were supported to buy and cook food that they enjoyed. Staff were aware of people’s dietary needs.
People’s family supported them with healthcare issues.
People and relatives felt that staff were caring and supportive and that most staff knew people well. Staff respected people’s wishes and respected their privacy and dignity.
People were asked about their support plans by staff using easy read documents and communication aids. People received the care they needed from staff to do the things that were important to them.
A complaints procedure was in place with easy read complaints forms. People were aware and knew who to go to if they had a complaint. Although some people told us that, they preferred to share any complaints with their relatives and, let the relative liaise with the provider.
Organisations registered with CQC have a legal obligation to tell us about certain events at their service. With the exception of one recent incident, the provider had made appropriate notifications to the CQC.
Communication between staff and management was not always effective leaving staff feeling with low motivation.
Audits and checks were used to ensure the safety and quality of service provided was maintained but these were not always effective.