Background to this inspection
Updated
25 July 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team was made up of one inspector.
Service and service type:
268 Ashingdon Road is a domiciliary care agency providing personal care to people living in their own homes. It provides a service to older adults including people with palliative care needs, physical disabilities and people living with dementia.
The service had recently recruited a manager who was going through the process of registering with the Care Quality Commission. In the interim the service was being managed by the registered provider who had previously been registered as the manager. The registered manager and provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This was an announced inspection as this was a small service and we had to be sure someone would be at the office when we visited. Inspection activity started on 24 May 2019 and ended on 3 June 2019. We visited the office location on 24 May 2019.
What we did:
Before the inspection, we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must let us know about, such as abuse; and we sought feedback from the local authority and other professionals involved with the service. We assessed the information providers send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
On 24th May 2019 we visited the office premises and spoke with the registered provider. We looked at four people’s care records including their medication records and daily notes. We looked at four staff files. We reviewed training and supervision records and documents relating to the management of the service including complaints and compliments, minutes of meetings and quality audits. on 3rd June 2019 we phoned four people who used the service to ask for their views. We also interviewed four staff members. We also contacted organisations that commission services from the provider including one local authority and a clinical commissioning group to ask for feedback.
After the inspection we made further requests for information which was provided by the registered provider.
Updated
25 July 2019
About the service:
268 Ashingdon Road is a domiciliary care agency that provides personal care to people living in their own homes. At the time of inspection 12 people were using the service.
People's experience of using this service:
People told us they felt safe using the service and valued the fact that they were supported by regular care staff who knew them well. People said they never had a missed call, staff arrived on time and stayed for the full length of the arranged visit and provided support in the way they wanted. People told us that the registered provider who was currently managing the service was helpful and approachable. People told us they had no complaints, were happy with the service they received and would recommend the service to other people.
Risks to people had been assessed with guidance for staff to follow. However, improvements were required in terms of risk recording to make sure people's care records were up to date and reflected people's current needs. Medicines were managed safely by staff who had been trained and assessed as competent. Staff had access to protective clothing to prevent the spread of infection. Sufficient staff were employed who had been safely recruited.
Staff received training, supervision and regular observations of their practice to ensure staff had the knowledge and skills to care for people effectively. People received support to have enough to eat and drink that met their needs and preferences. Staff knew people well and reported any health concerns to the registered provider who made appropriate referrals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.
People told us staff were kind and caring and treated them with dignity and respect. Staff were gentle and compassionate when providing care and support and listened to people. Independence was supported and encouraged.
Improvements had been made to how information about people was collected to help staff get to know people and how they wanted their care and support delivered. There were systems in place to respond appropriately to complaints. Staff had received training in end of life care and feedback from people showed that people and their families received kind and compassionate care.
The registered provider was managing the service whilst a new manager was completing their induction and going through the registration process. Improvements had been made to ensure robust quality assurance mechanisms were in place to monitor the safety and quality of the service. The registered provider had a good level of oversight of their service as often worked out in the field providing care and support to people and overseeing staff practice. They were pro-active at seeking the opinion of people and staff to drive improvements and ensure people were happy with the service they received.
Rating at last inspection: Requires Improvement. (Last report published June 2018).
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk