Background to this inspection
Updated
21 July 2017
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 inspection of the office and visiting people in their own homes with their permission took place on 23 May 2017 and was announced. We spoke with further people using the service and relatives on 7 June 2017. The inspection team consisted of one inspector.
Before our inspection we reviewed the information we held about the service, which included safeguarding alerts and statutory notifications which related to the service. Statutory notifications are information about important events which the provider is required to send us by law.
We focused on speaking with people who used the service, their relatives, speaking with staff and professionals.
We visited five people who used the service and spoke with a further four people who used the service and four relatives. We also spoke with the registered manager, delivery manager, scheduler, field care manager, care coach for new staff and three care staff members.
We looked at seven people’s care records and medicine records, staffing rotas and records which related to how the service monitored staffing levels and the quality of the service. We also looked at information which related to the management of the service such as health and safety records, quality monitoring audits and records of complaints.
Updated
21 July 2017
The inspection took place on 23 May and 7 June 2017 and was announced. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available. The service provides personal support to 80 people by arrangement in their home in the local area.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Staff had attended training to ensure they had a good understanding of their roles and responsibilities; this included how to safeguard people. Staff knew how to report matters to the appropriate authorities if they suspected abuse was happening. The manager knew how to share information with the local authority when needed.
People were supported usually by a sufficient number of suitably skilled staff, other than one person. The service did usually advise when the call could not be made and was actively recruiting staff in that area to resolve the situation.
The manager had ensured appropriate recruitment checks were carried out on staff before they started work. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred.
The provider had systems in place so that staff were trained to administer medicines and people were supported to take their prescribed medicines safely.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
We checked whether the service was working within the principles of the MCA and noted that staff had received training in mental capacity assessments and best interest meetings.
The staff responded to people’s needs in a compassionate and caring manner. Positive and supportive relationships had been built up between the staff, people using the service and relatives. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were supported and enabled to be as independent as possible in all aspects of their lives.
Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People and family members were involved in the planning and reviewing of their care and support.
People’s health needs were managed appropriately with input from relevant health care professionals. The service had worked with GP’s and other professionals to arrange appointments and carry out support as instructed. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health. Staff ensured that people’s health needs were effectively monitored.
The management was of a supportive culture and staff were supported to provide care that was centred on the individual. The manager and senior staff were approachable to people using the service and staff and enabled people who used the service to express their views. All of the senior staff had particular roles to perform, upon which they were clear, in order to provide a smooth running service.
People were supported to report any concerns or complaints and they felt they would be taken seriously. People, who used the service or their representatives, were encouraged to be involved in decisions about the service. The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.