The inspection took place on 19 May 2015. At the last inspection in October 2013 the service was not meeting the regulation around the safe management of medicines. We saw that the provider had completed the actions from their action plan after the inspection and they now met the requirements of this regulation.
The service is a domiciliary care agency, providing care for 245 people in their own homes at the time of our inspection and employs 106 staff at this location. There was a registered manager for the service. 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 were protected from harm and abuse by staff who had a good understanding of how to protect people. The staff members we spoke with all knew the different types of abuse and were confident in the processes to report any concerns or abuse they have witnessed. People had clear risk assessments that detailed the risks to them with guidance for staff to follow to make sure people were kept safe. There were enough staff to provide people with safe care.
People’s medicines were managed safely. Since our last inspection the provider had developed new systems to safely record and administer people’s medicines to support their health needs.
People were supported by staff who were well trained and supported in their work. Staff had completed training, which the provider considered to be essential training and were able to request additional training. They received regular supervision and support from their managers. This made sure staff had the skills and support they needed to support people safely and effectively.
People were asked for their consent for care. We saw that people’s views and consent for care were sought and care and people’s rights and freedoms were respected.
People were supported to maintain a balanced diet and were given the food and drink they needed. We saw that people were given choices about their food and were happy with the support they received. People’s health was monitored and the provider worked with other services involved in people’s care to make sure they received the correct care.
Staff members had caring relationships with people who used the service. People had regular carers who knew them well and understood their needs and preferences. Care workers involved people in making decisions about their care and supported people to maintain their independence. People’s privacy was respected by care staff who made sure they maintained people’s dignity when providing them with personal care.
People had care plans that were tailored to meet their individual needs. We saw care plans were regularly reviewed and updated to reflect people’s changing needs and preferences. The care plans had personal information and details of people’s backgrounds and detailed the ways that people wanted to receive their care. People told us these care plans were followed by staff and they received the care they needed.
The provider had a clear complaints procedure and people felt confident in raising any concerns or making a complaint about the service. Complaints were dealt with in the timescale set out within the policy and we saw examples of feedback given to people following complaints and suggestions.
The service had an open culture that supported people and staff to talk about their experiences of the service and encouraged people to give their feedback and ideas for improvement. Staff were involved in regular team meetings and given the support they needed to increase their skills and confidence in providing good care. The registered manager had a visible presence in the service and was approachable for staff, people using the service and their relatives to discuss their care and service received.
The provider had a quality assurance system in place to audit and monitor the quality of the service. We saw details of regular audits of care files and staff files, and an annual survey was completed with the results of the survey being sent to people using the service.