Background to this inspection
Updated
2 December 2015
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 was 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.
The inspection began with a visit to the services office which took place on 19 October 2015. The provider was given short notice of the visit in line with our current methodology for inspecting domiciliary care agencies. The inspection team consisted of an adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We spoke with seventeen people who used the service, or their representative, by telephone and visited three people in their home’s to discuss the service the agency provided. When we visited people we also spoke with two relatives. We spoke with the registered manager, the office manager and six staff who were either care workers or employed at the office.
To help us to plan and identify areas to focus on in the inspection we considered all the information we held about the service, such as notifications. Before the inspection, the provider completed a 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 obtained the views of service commissioners and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We looked at documentation relating to people who used the service and staff, as well as the management of the service. This included reviewing five people’s care files, staff rotas, staff training and support records, four staff recruitment files, medication records, audits, policies and procedures.
Updated
2 December 2015
The inspection took place on 19 October 2015 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected on 8 May 2014, when no breaches of legal requirements were identified.
Homecare4U 8 Cavendish Court is situated on the outskirts of Doncaster town centre. The agency provides personal care to people in their own home. At the time of our inspection the service was supporting people with a variety of care needs including older people, people living with dementia, and younger people with physical disabilities.
The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.
At the time of our inspection there were 75 people receiving personal care from the service. We spoke with nine people who used the service, and thirteen relatives, about their experiences using the agency. The majority of people we spoke with told us they were entirely happy with the service provided.
People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we sampled was individualised and identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in
Changes in people’s needs had been quickly identified and their care package amended to meet their changing needs. Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role. However, we found information about prescribed medication sometimes lacked detail.
The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.
Overall we found the service employed enough staff to meet the needs of the people being supported. Most people we spoke with raised no concerns about how the service was staffed, but some said they would prefer a more consistent staff team. Most staff we spoke with also felt additional staff would be beneficial.
There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We found most staff had received a structured induction and essential training at the beginning of their employment. This had been followed by regular refresher training to update their knowledge and skills.
Staff told us they felt well supported and received an annual appraisal of their work performance. However, although staff received supervision sessions and spot checks to assess their capabilities and offer support, these had not always happened consistently.
The company had a complaints policy which was provided to each person in the information pack provided at the start of their care package. When concerns had been raised we saw the correct procedure had been used to investigate and resolve issues. The people we spoke with told us they were happy with the service they received.
The provider had a system in place to enable people to share their opinion of the service provided. We also saw an audit system had been used to check if company policies had been followed. Where improvements were needed the provider had put action plans in place to address these.