Background to this inspection
Updated
17 August 2018
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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.
This service was previously inspected in April 2017. At that time, we found there were areas that required improvement. One adult social care inspector carried out this inspection.
Prior to the inspection we looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law.
Before the inspection, we had asked the provider to complete 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 planned to make. We reviewed the information included in the PIR and used it to assist in our planning of the inspection.
We contacted and spoke with four people who used the service, and four members of staff. We spent time with the area manager and care co-ordinator. A regional director from the Midlands was present to support staff during the inspection where required. We looked at four people’s care records, together with other records relating to their care and the running of the service. This included the policies and procedures relating to the delivery and management of the service, surveys, minutes of meetings, accidents, incidents, complaints, compliments and, audits and quality assurance reports.
Updated
17 August 2018
This inspection started with a visit to the office on 28 June 2018 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. On 3 July 2018 we made calls to people who use the service and staff to gain their views and experiences.
The inspection was carried out by one adult social care inspector. This service is a domiciliary care service. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of this inspection the service was providing the regulated activity of personal care to 34 people. These services were managed from an office in Kingswood, Bristol.
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. The registered manager was based in another branch, however there was a care manager in the Bristol branch who ran the office on a day to day basis. The area manager for the area, also had a base in the office and provided support to the care manager as needed.
At the inspection of April 2017, we rated the service overall as Requires Improvement. At that inspection, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed safely. We also recommended that audits of the service needed to improve as they were not effective.
Following the inspection, we told the provider to send us an action plan detailing how they would ensure they met the requirement of the regulation. At this inspection, we saw the provider had taken action as identified in their action plan. In addition, they had sustained previous good practice. As a result of this inspection, the service has an overall rating of Good.
Why the service is rated Good
The feedback we received from people and staff was positive throughout.
The safety of people who used the service was taken seriously and the care manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.
The staff team were motivated and proud of the service. All staff were fully supported by the care manager and the care co-ordinator. A programme of training and supervision enabled them to provide a good quality service to people. The care manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.
The care manager ensured staff understood people’s care needs and had the skills and knowledge to meet them. People received consistent support from staff who knew them well. People had positive, caring relationships with staff and were confident in the service. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care was amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views, however a recent customer satisfaction survey identified that consistency in communication from the office needed to improve.
People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The care manager was committed to continuous improvement. The service demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.