We undertook an announced inspection on 16 February 2016.We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.The provider registered this service with us to provide personal care to people who live in their own home. At the time of our inspection 30 people received care and support services in their own home. Services provided are for adults who may have a range of needs which include end of life care, complex health conditions which include physical disabilities and dementia.
At the time of our inspection a registered manager was 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.
People told us they felt safe with all of the staff who provided care and supported them in their homes. There were arrangements in place to make sure there were sufficient staff employed who understood the need to protect people from the risk of harm and abuse The registered manager had taken measures to reduce risks to people’s safety. Staff were trained in how to recognise abuse and understood the action they should take if they had any concerns people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.
People’s care plans included risk assessments for their health and wellbeing and explained the actions staff should take to reduce the identified risks. Staff understood people’s needs and abilities by working alongside experienced staff when they started working at the service, speaking with people about their needs and reading care plans.
The registered manager assessed risks in each individual person’s home and advised staff of the actions they should take to reduce the risks. Where people needed support to take their medicines these were administered by staff who had been trained to do so. The registered manager had procedures in place to check people received their medicines as prescribed, in accordance with their health needs.
Staff received training and support which supported them to meet people’s needs effectively. Staff had opportunities to reflect on and improve their practice for the benefit of providing people with care and support to effectively meet their care needs.
People and relatives told us they were always asked for their consent before staff provided care and support to them in their homes. When people did not have the capacity to consent to their care the registered manager had arrangements in place so people’s rights were upheld and staff worked within the requirements of the law.
People told us that they were happy with the way in which staff helped them with their meals and in accessing health care services when they needed them to get the best outcomes for people’s health and well-being.
The registered manager asked people about their preferences for care during their initial assessment of needs. Staff supported the same people regularly so they learnt about people’s likes, dislikes and preferences for care. The registered manager regularly delivered care and support, so they maintained an on-going relationship with each person.
People told us the staff who provided care and supported them in their homes were kind and respected their privacy, dignity and independence and said staff felt like their friends. People knew any concerns would be listened to and action taken to resolve any issues. Records showed the registered manager learnt from complaints and adopted policies to reduce the risk of similar complaints in the future.
People were encouraged to share their opinions about the quality of the services provided during visits by the registered manager and senior staff members, at regular reviews of their care plans and through formal surveys.
The registered manager and staff team shared common values about the aims and objectives of the services they provided to people in their homes. People were supported and encouraged to live as independently as possible, according to their needs and abilities.
The registered manager’s quality checking arrangements included regular checks of people’s care plans and staff’s practice. When issues were identified action was taken to continually improve and develop the quality of the services provided to people in their homes.