Background to this inspection
Updated
1 December 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 was the first inspection for this location.
The inspection visit to the office took place on 15 September and was announced. We told the provider in advance we were visiting, so they had time to arrange for us to speak with people who used the service. The inspection was conducted by two inspectors.
We reviewed the information we held about the service. We looked at information received from local authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided. We also looked at statutory notifications sent to us by the service. A statutory notification is information about important events which the provider is required to send to us by law.
A provider information return (PIR) was not requested before the inspection. We gave the registered manager the opportunity during the visit to tell us what the home did well and what areas could be developed.
During our inspection visit, we spoke with the registered manager, the operations manager, the service manager, three assistant managers and five care staff. We also spoke with four people who used the service, and four relatives over the telephone.
We reviewed six people’s care plans, to see how their care and support was planned and delivered. We looked at other records related to people’s care and how the service operated to check how the provider gathered information to improve the service. This included medicine records, staff recruitment records, the provider’s quality assurance audits and records of complaints.
Updated
1 December 2016
This inspection took place on 15 September 2016 and was announced.
People in Action Domiciliary Care – South Warwickshire, provides care to younger adults with a learning disability or with mental health difficulties, in their own homes. Some people live with family members, whilst others live in homes they share with other people supported by the provider. At the time of our inspection, the provider was supporting 23 people.
The service had a registered manager. 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. Whilst we spoke with the registered manager, and established they had oversight of the service, a ‘service manager’ was in post and oversaw the day to day running of the service.
People told us they felt safe and comfortable with the staff who supported them. Most relatives were also confident people were safe. Staff received training in how to safeguard people from abuse, and were supported by the provider who acted on concerns raised and ensured staff followed safeguarding policies and procedures. Risks to people’s safety were mostly identified, minimised and focussed towards individual needs so people could be supported in the least restrictive way possible and build their independence. However, some risk assessments were not up to date and had not been completed where risk had been identified.
People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. People told us their medicines were given in a timely way and as prescribed.
There were enough staff to keep people safe, but recruitment was underway to ensure there was a full staff team able to meet people’s individual needs. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived independently. Staff told us they had not been able to work until these checks had been completed.
People told us staff asked for consent before providing them with support. People were mostly able to make their own decisions and staff respected their right to do so. Staff and the service manager had a reasonable understanding of the Mental Capacity Act 2005, and the provider had ensured applications to deprive people of their liberty under the Deprivation of Liberty Safeguards, had been made as required.
People had access to health professionals when needed, and care records showed support provided was in line with what had been recommended.
People told us staff were kind and caring and treated them with dignity. Most relatives agreed, although some staff and relatives had concerns about the way some staff spoke with people. We found the provider took this seriously and was taking steps to deal with this. People were supported to make choices about their day to day lives. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, their likes, dislikes and preferences.
Relatives told us, and records confirmed, that people were not always supported in a responsive way, or according to their preferences and needs. Frequent staff changes along with reduced staffing levels, led to people’s support being changed from what was planned, in order to free staff up to cover gaps elsewhere in the service. People and most relatives felt able to raise any concerns with the service manager. They felt these would be listened to and responded to effectively and in a timely way.
Staff told us the service manager was approachable and responsive, but that they did not always feel well supported by senior staff who they felt were less available and responsive following recent organisational changes. There were systems in place to monitor the quality of the support provided, but these had not always identified the issues we found, and actions plans were not sufficiently robust to enable the service to continually improve.