23 September 2014
During a routine inspection
At the time of our inspection there were 48 people receiving care at the home or in their own homes. We spoke with four people using the service about their experiences. We also spoke with two relatives, five staff, the provider and the home care team leader. The registered manager was on holiday at the time of our inspection.
We considered all the evidence we had gathered under the outcomes we inspected. We looked at respecting and involving people in their care, the care and welfare of people, medicines management, the recruitment of staff and assessing the quality of the service and records. We used the information to answer the five questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found.
Is the service safe?
The service was safe overall however we had concerns about the auditing arrangements for the effective management of people's medicines was not adequate and the documentation of medicine administration was inaccurate. This put people at risk of not receiving their medicines as prescribed. People were at risk of not receiving their medicines safely and consistently and according to their needs.
Is the service effective?
The service was effective because risk assessments were carried out and care plans developed to show how people's assessed needs would be met. The staff were knowledgeable about the people they cared for.
Is the service caring?
We saw people were supported in a caring and compassionate way. Staff and people using the service had developed good relationships and people were treated with respect. People told us they were able to exercise their choices and staff listened to them. People were complimentary about the care and support they received. People who used the service told us they felt involved and respected by staff, their views listened to and concerns acted on in a timely fashion Comments included 'as 'staff are respectful and pleasant', 'they have been great getting to my relative in the bad weather' and 'staff do an excellent job'.
Is the service responsive?
The service was responsive because people told us told us they were satisfied with the care and support they were receiving. We saw people were supported to access external healthcare facilities as needed. People who used the service told us the staff were very knowledgeable and understood their needs well. They told us the staff reacted to changes in their needs quickly and sought assistance as required. For example, accessing the district nurses for support with a leg ulcer and reassessing care and adjusting the care package following a series of falls.
Is the service well-led?
There were mainly systems in place to regularly assess and monitor the quality of service provided. There was a complaints process in place to support people to raise their concerns and information was available to people.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the monitoring of medicine administration.