The inspection took place on 13, 14 and 20 December 2016 and was announced. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available. The service provides personal care to people in their own homes. The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 knew how to protect people from potential abuse as they had attended training and were able to inform us what actions they would take should they suspect abuse. Staff had also learned from training how to support people appropriately and to facilitate their independence by providing them the support they needed. Staff used support plans and risk assessments to plan and record how they met people’s needs in a safe way.
People were supported by a sufficient number of suitably experienced and knowledgeable staff. The manager had ensured appropriate recruitment checks were carried out on staff before they started work. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred.
The provider had systems in place so that staff were trained to administer medicines and people were supported to take their prescribed medicines safely.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received training in mental capacity assessments, best interest and were competent to work with relevant professionals. This ensured that decisions were taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.
The staff responded to people’s needs in a compassionate and caring manner. Positive and supportive relationships had been built up between the staff, people using the service and relatives. People were supported to make day to day decisions and were treated with dignity and respect. Choices about what people wanted to eat, where they intended spending Christmas and how to spend their lives were discussed, implemented and recorded in the persons support plan.
Staff were supported and supervised in their roles and all had an annual appraisal. People and when appropriate family members were involved in the planning and reviewing of the support provided. The service also worked with other professionals to support the people the using the service.
The health needs of people were overseen with input from relevant health care professionals. The service had worked with GP’s and Occupational Therapist to arrange appointments with these professionals and carry out support as instructed.. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health.
People were supported to report any concerns or complaints and they felt they would be taken seriously. People who used the service, or their representatives, were encouraged to be involved in decisions about the service.
Support plans had been reviewed and we saw that they had been written with the individual and were person-centred. The management were supportive of its staff and promoted a person centred approach to the care and support it provided. The manager and senior staff were approachable to people using the service and staff and enabled people who used the service to express their views.
The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service. The service also consulted with other professionals for their views about the service so that these could be considered and used to drive the organisation forward.