Background to this inspection
Updated
26 November 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 is 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 was undertaken by one inspector, took place on 22 and 23 September, and 2 October 2015 and was announced. The provider was given 24 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.
We reviewed information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with the director, the registered manager and five members of staff. We also visited one person in their own home who used the service, and spoke with a relative, and a citizen advocate who had supported a person who had received personal care from Beyond Limits.
We looked at two records related to people’s individual care needs. These included support plans, risk assessments and daily monitoring records. We also looked at six staff recruitment files and records associated with the management of the service, including quality audits.
Updated
26 November 2015
The inspection took place on 22 and 23 September, and 2 October 2015 and was announced. The provider was given 24 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.
Beyond Limits provides a personal care service to people living in their own home. On the day of the inspection two people were supported by Beyond Limits with their personal care needs.
The service had a registered manager 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.
On the day of the inspection staff within the office were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.
People, those who matter to them, staff and professionals all spoke positively about the service. Comments included, “I like the whole ethos of Beyond Limits. It’s all about empowering people and helping them to live as independent lives as possible”, “I love everything about the company. They listen to people and are totally caring” and “I can’t find fault with Beyond Limits”.
People told us they felt safe. All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.
People were involved in recruitment and had the final say on who was employed to their unique team of staff. Staff teams for each individual, received a tailored comprehensive training programme that reflected the person’s needs, and supported how that person wanted and needed to receive their care.
People told us staff provided consistent personalised care and support. Care records were focused on empowering people to have control. Staff responded quickly to people’s change in needs. People and those who matter to them were involved in identifying their needs and how they would like to be supported. People’s preferences were sought and respected. Staff focused upon a person’s whole life. People’s life histories, strengths, ambitions, hopes and dreams were taken into account, communicated and recorded.
People were promoted to live full and active lives and were supported to go out and use local services and facilities. Activities were meaningful and reflected people’s interests and individual hobbies.
People received consistent co-ordinated care when they moved between services. Proper plans were drawn up and delivered in practice. People were involved and their preference and choices respected. Strategies had been put in place to maintain continuity of care.
People where appropriate were supported to maintain a healthy balanced diet.
People’s risks were anticipated, identified and monitored. Staff managed risk effectively and actively supported people’s decisions, so they had as much control and independence as possible.
People had their medicines managed safely. People were supported to maintain good health. Referrals were made quickly to healthcare professionals, such as GPs, physiotherapists and occupational therapists when people’s needs changed.
People knew how to raise concerns and make complaints. People and their relatives who had raised concerns confirmed they had been dealt with promptly and satisfactorily.
Staff put people at the heart of their work; they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed and practice was person focused and not task led. Staff were highly motivated, and had good appreciation of the importance of respecting people’s individual needs around their privacy and dignity.
Staff described the management to be very open, supportive and approachable. Staff talked about their jobs in a strong positive manner. Comments included, “The management team are always on hand to offer support and listen”, “I absolutely love my job” and “You are made to feel appreciated”.
Staff were encouraged to be involved and help drive continuous improvements. This helped ensure positive progress was made in the delivery of care and support provided by the service.
There were effective quality assurance systems in place. Action was taken to address areas where improvements were needed, and as a result, changes had been made to drive the service forward.