This inspection took place on 11 and 13 November 2015. We gave the provider 48 hours’ notice of our inspection to ensure members of the management team would be available at the office, and to ensure they could make arrangements for us to meet with and speak to staff.
We last inspected this service in December 2013. At that time the provider was meeting all of the regulations we looked at.
Your Care Services was providing support to 26 people living in their own home. People required support from the service because they had either complex physical health needs or were living with dementia.
There was 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.
People and the relatives of people using this service told us they felt their relatives were safe. Staff understood how to protect people from abuse. There were processes to minimise risks associated with people’s care to keep them safe. This included the completion of risk assessments and recruitment checks on staff to ensure their suitability to work with people who used the service. There were enough suitably trained care staff to deliver care and support to people.
The staff employed had the training and support they required to work safely. Training for staff about the specific needs people experienced had also been provided.
Most people had regular care staff who usually arrived on time and stayed the agreed length of time. Two relatives told us they had experienced call times that were too early or late but that in the weeks leading up to our inspection this had improved.
Senior staff had visited each of the people using the service at their home. They had met with them and their family to determine what care and support the person required, and how they would like this care to be provided. This information had then been developed into a care plan, and shared with staff that were supporting the person. This ensured all staff were aware of the person’s needs and wishes.
The managers understood the principles of the Mental Capacity Act (MCA), and staff told us how they respected people’s decisions and gained people’s consent before they provided personal care.
People who required support had enough to eat and drink during the day and were assisted to arrange health appointments if required. Staff we spoke with were able to describe a range of activities they undertook each day which ensured people stayed healthy and how they observed people’s skin for signs of sore areas for example when they were supporting them with personal care.
People told us staff were kind and caring and had the right skills and experience to provide the care and support they required. Staff we met spoke enthusiastically about the people they were supporting, and were able to explain people’s needs, their preferences and were aware of important people in the person’s life.
The provider sought feedback from people using the service and their relatives in respect of the quality of care provided and had arrangements in place to deal with any concerns or complaints. The registered provider had developed a complaints procedure. People said they knew how to raise complaints and knew who to contact if they had any concerns. All of the staff we spoke with were confident they could raise any concerns with the managers, knowing they would be listened to and acted upon.
There were some processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through communication with people and staff, spot checks on staff and a programme of other checks and audits although these were not always effective in identifying how the service could be improved.