This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of all ages, including people with dementia or physical disabilities. This was the first inspection of this service. 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, which is help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the start of our inspection there were 12 people using the service in this respect.
The service had a registered manager which 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.
There was overall positive feedback about the service, from people using it and their relatives and representatives. Everyone said they would recommend the service to friends and family.
We found people were treated with kindness, respect and compassion. Their privacy, dignity and independence was respected and promoted. Staff were consistently described as ‘caring’.
People's needs were comprehensively assessed to help ensure their specific needs were identified and addressed. The registered manager demonstrated good knowledge of the community resources available in support of meeting people’s needs. The service, therefore, worked well in co-operation with other organisations to deliver effective care and support.
People received personalised care that was responsive to their needs. The service people received was kept under review and adjusted accordingly. People were regularly supported to express their views and be actively involved in making decisions about their care and support.
The service supported people to receive ongoing healthcare support. People were supported to eat and drink enough. Referrals were made if concerns arose.
Consent was obtained before personal care was provided. Where anyone could not make that decision, the service was working towards ensuring an assessment, in line with the principles of the Mental Capacity Act 2005 (MCA), occurred.
There were sufficient numbers of suitable staff to support people. Overall, staff had the skills, knowledge and experience to deliver effective care and support. Staff were supported in their roles, for example, through developmental supervision. The registered manager worked closely with new staff to make sure they were equipped to meet people’s needs before letting them work alone.
We identified areas where the service could not consistently demonstrate safe practices. Whilst there were systems of checking whether people were supported to take medicines as prescribed and that involved staff had sufficient competency, these were not clearly documented. Documents such as risk assessments, care plans, and medicines records were not consistently dated. This had potential to undermine the accuracy of these records when needed, such as for reviews or investigations.
Where the service supported people with medicines management or to move around, risks were not comprehensively assessed to minimise the chances of unsafe support. However, the registered manager provided prompt updates to these assessment process records soon after the inspection visit.
Any safety risks identified for individuals were well managed in practice, such as through making community support referrals or advising the person using the service or their representative. The service also upheld good standards of cleanliness when working with people, which helped prevent infection.
The registered manager demonstrated appropriate leadership values such as through wanting to ensure staff could provide good care when first working with someone new to the service, and pursuing matters in practice to ensure people received safe and responsive care. Systems at the service enabled sustainability and supported continuous learning and improvement.