Background to this inspection
Updated
3 March 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 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.
Before the inspection we looked at all the information we held about the service. This information included the statutory notifications that the service had sent to Care Quality Commission. A notification is information about important events which the service is required to send us by law. The provider had sent us a completed 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 plan to make. We also contacted social care professionals and the local authority safeguarding team for feedback about the service. We used this information to help inform our inspection planning.
This inspection took place on 30 and 31 October 2017and was announced. The provider was given 48 hours’ notice because the service is a domiciliary care service and we needed to be sure that the provider would be in. The inspection was carried out by one inspector and an expert by experience. The expert by experience carried out phone calls to people and their relatives. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
During the inspection we looked at seven people’s care records and seven staff records. We also looked at records related to the management of the service such as details about the administration of medicines, accidents and incidents, safeguarding, and quality assurance and monitoring. We spoke with four people who used the service and 14 relatives about their experience of using the service. We also spoke with the nominated individual, the registered manager and seven members of staff.
Updated
3 March 2018
This announced inspection took place on 30 and 31 October 2017.
This was the provider’s first inspection since they re-registered in December 2016 having previously operated at a different address since 2013. The service is a domiciliary care agency. It provides personal care to people living in their own home. Not everyone using Home Instead Senior Care – Bromley, Chislehurst & Orpington receives regulated activity; 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 76 people were using the service with 40 of these receiving personal care.
The service had 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.
Staff always treated people and their relatives with kindness, dignity and respect. People and relatives told us that staff were always caring and kind. People's privacy and dignity were respected and promoted when personal care was undertaken. People and relatives felt that staff went over and above to provide exceptional care to people. For example one person was regularly visited by staff when they had a period in hospital.
The provider, registered manager and staff were aware of the importance of providing outstanding care to people. People and relatives were highly complimentary of how the service was run and managed and all staff at the service. Staff fedback they felt supported and valued by the management and were listened to. There were effective systems to assess and monitor the quality of the care people received. Feedback from people and relatives showed that there were extremely high levels of satisfaction in respect of the care provided.
People and their relatives told us they felt safe with the staff. The service had clear procedures to recognise and respond to abuse. All staff completed safeguarding training. Senior staff completed risk assessments for people who used the service which provided sufficient guidance for staff to minimise identified risks. The service had a system to manage accidents and incidents to reduce reoccurrence.
The service had enough staff to support people and carried out robust background checks on staff before they started working to ensure only the right staff were employed. The service had an on call system to make sure staff and people had support outside the office working hours. Staff supported people so they took their medicine safely. The service provided an induction and training, and supported staff through regular supervision and annual appraisal, which included competency checks and regular team meetings to help them undertake their role.
People’s consent was sought before care was provided. The registered manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and only acted in people’s best interest.
Some staff supported people to buy their shopping and plan and prepare meals. Staff supported people and their relatives to enable people to access appointments if needed and liaised with health and social care professionals involved in their care if their health or support needs changed.
People and their relatives told us they were consulted about their care and support needs. Care plans were detailed, reviewed regularly and were up to date. The service had a clear policy and procedure for managing complaints. People knew how to complain and would do so if necessary however there had been no complaints received since the service had been registered.