Archived: First Key Hereford

Updated 8 November 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 service was last inspected on 13 June 2013.

We made an announced inspection on 8 September 2016. The inspection team consisted of one Inspector. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available in the office.

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. This information helped us to focus our inspection.

We looked at the information we held about the service and the provider. We asked the local authority if they had any information to share with us about the care provided by the service.

We spoke with four people who use the service and six relatives. We also spoke with an external training provider and a health professional. We spoke with the registered manager and four staff members. We looked at three care records, which included risk assessments, reviews of people’s care and healthcare information. We looked at the provider’s quality assurance systems, including feedback and the complaints procedure.

Updated 8 November 2016

First Key is located in Hereford, Herefordshire. It is domiciliary care agency which provides support to people in their own homes. It supports people with learning disabilities, physical disabilities, people living with dementia and people with mental health conditions. On the day of our inspection, there were 30 people using the service. Due to people’s complex needs, the majority of people using the service received 24 hour care from the provider and the average call length for people was eight hours.

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 encouraged to take responsibility for their own safety and keeping themselves safe. People were made aware of their rights and what was acceptable and unacceptable treatment of them.

People were only cared for by staff they felt safe and comfortable with, and they were involved in decisions about who would the provider employed.

People were supported by a skilled and well-trained staff team. Staff used ongoing training to reflect on their practice and ensure people's health and wellbeing needs were met.

People were supported with eating and drinking and to maintain a healthy weight. Where there were concerns over people's health, specialist input was sought from a range of health professionals.

People's communication needs were known by staff and different communication methods were used to ensure people were involved in decisions about their care.

People were supported by a respectful staff team who enjoyed working with people and helping them to achieve their goals.

People's changing health and wellbeing needs were responded to. People's individual preferences were taken into account and used to tailor people's care to meet their needs.

People knew how to complain or provide feedback and were confident that action would be taken.

The provider's emphasis was on inclusion and valuing diversity, both in terms of people and staff. The provider promoted a positive image of disability and focused on what people could achieve.

Staff felt supported by the registered manager and provider, and felt a sense of pride about working for the organisation and in its values.

People were involved in the running of the service and in the day-to-day running of the office.