Background to this inspection
Updated
6 January 2021
The inspection
As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission conducted an inspection of this provider on 25 November 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as electronic file sharing, video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.
Inspection team
This inspection was carried out by two inspectors, one medicines inspector, and one 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of the inspection the registered manager was on leave. The management of the service was being overseen by a head of operations manager, a business support manager and an assistant manager.
Notice of inspection
We gave a short period notice of the inspection as we needed to be sure that the appropriate people would be available to support the inspection.
Inspection activity started on 25 November and ended on 4 December 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with seven people who used the service and eight relatives about their experience of the care provided. We spoke with nine members of staff including the nominated individual, head of operations manager, business support manager, assistant manager, operational administrator and care staff. We received feedback from one healthcare professional.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service, including audits, training and supervision records and we reviewed policies and procedures.
Updated
6 January 2021
This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the COVID -19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
About the service
Care at Home Service - Henleaze Road is a domiciliary care agency providing personal care. At the time of our inspection, they were delivering care to 77 people.
People’s experience of using this service and what we found
People and relatives spoke extremely positively about the service they received. We were given many examples that showed people received quality care and support from kind, caring staff that ensured people were kept safe, were happy and felt well cared for.
People and their relatives described the staff as being polite, friendly, courteous, kind and respectful. One person said, “They have helped me build my confidence since coming to me.” Another described the staff being “More like family relationship with them."
Each person benefited from a regular staff member who knew them well. People told us they had developed positive, caring relationships with their regular staff. Comments included, “Carer is a real gem – very caring.” And, “They [staff] are very careful with my husband – all very nice girls.”
Staff spoke knowledgably regarding all aspects regarding safeguarding people. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.
Risks were individually assessed, regularly reviewed, clear and covered all areas of people’s health as well as any potential environmental risks. Risks assessments ensured staff were given current guidance and information to enable them to support people safely whilst allowing them to maintain their independence.
People were supported by sufficient numbers of trained, experienced staff to meet people’s needs. People received their support from a consistent team of skilled staff that knew people well and delivered their care in ways people preferred.
People received their medicines safely because medicines were well managed.
There were robust procedures in place to ensure people were protected from infections that could affect both staff and people using the service. Staff had completed infection prevention and control training and understood the actions needed to minimise the risk of avoidable harm, including the prevention of avoidable infection. Staff had access to plentiful supplies of personal protective equipment (PPE) and followed current national guidance regarding the COVID -19 pandemic.
People, relatives and staff consistently spoke of the passion, commitment, kindness and approachability of staff at all levels. People felt the service was well led with a strong commitment to providing the very best person-centred care.
Staff told us, and records showed, there was an open, honest, positive culture with a strong ethos on learning and development. Staff were provided with mandatory training, however a member of staff said they had requested Parkinson's training that hadn't been provided to them yet. We fed this back to the management team and they told us any specific healthcare training would be provided as the need arose. Other staff said they had received training in diabetes when they were providing support to someone with diabetes.
Governance systems and oversight of the service were robust. Issues were identified, analysed and discussed with staff to enable learning to be achieved from incidents. There was an open, supportive culture that empowered staff to put forward their ideas for improvement to enable people to receive quality, individualised care that impacted positively on their lives.
People, relatives and staff consistently spoke of the effective and clear communication. One member of staff told us, “Communication here is simply brilliant, everything is instant, we have all the information we need straight away, I can’t fault it.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had a good understanding of the Mental Capacity Act 2005.
People received a personalised service to meet their specific needs, preferences and wishes. People were involved in making decisions about their care and supported to maintain their independence. Care plans were personalised, very detailed and up to date. This meant staff had the information they needed to deliver appropriate care.
People, relatives and staff were encouraged to share their views about the service to make improvements and to recognise good practice. Regular checks were made to monitor the quality and safety of service provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection – The last rating for this service was Good (published 6 February 2018).
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the COVID -19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care at Home Service - Henleaze Road on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.