This inspection took place on 13 November 2018 and was announced as Heather Day Care (known as Heather Care) is a small service and we wanted to ensure staff would be available to speak with us.Heather Care is registered to provide personal care to people in their own homes. Not everyone using the service receives a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the service was providing personal care support for two people.
Heather Care also provides a day care service for older people and an educational service for people with a learning disability. These parts of the service are not regulated by the CQC and were not part of this inspection. The care staff who supported people in the domiciliary care service also worked in the day care service.
Heather Care 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. We were told the office manager was due to apply to become the new registered manager for the service.
At our last inspection in October 2017 we found three breaches in Regulations because care staff had not received the relevant training for their role, medicines administration was not recorded and the governance of the service had not identified these shortfalls.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective and well led to at least good.
At this inspection we found improvements had been made and all regulations were now being met.
Medicines were safely managed. Staff were aware of what constitutes prompting people with their medicines and administering them. All medicines that were administered were recorded.
Staff had completed training relevant to their role. They received support from the office and registered managers through supervision and staff meetings.
Due to the small nature of the service formal quality assurance systems were not currently in place. The office manager planned to introduce unannounced spot checks to check the care files in people’s houses and ask them about the support they receive.
We discussed how the quality assurance systems would be developed if the service expanded.
Person centred care plans and risk assessments were in place and regularly reviewed. People and their relatives or representatives were involved in agreeing their care plans.
Where assessed as part of the care plan, people were supported to maintain their health and nutritional intake.
Care staff knew people’s needs well, including the tasks people could do for themselves and how to maintain their privacy and dignity when providing personal care.
People, relatives and legal representative said the staff were kind and caring. They said the care staff would contact them if there were any changes in people’s needs or health.
Heather Care was meeting the principles of the Mental Capacity Act (2005).
There had not been any accidents or incidents in the domiciliary care service. A policy was in place to review these if any did occur. The office manager told us they reviewed any accidents or incidents that had occurred in the day centre service. We have made a recommendation for the service to follow best practice guidelines with regard to recording the outcome of any review of an accident or incident.
The service had not recruited any staff since our last inspection. A procedure was in place for the safe recruitment of new staff.