Background to this inspection
Updated
6 December 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector and an assistant inspector carried out this inspection.
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.
Notice of inspection
We gave the service 72 hours' notice of the inspection visit because we needed to make sure the registered manager would be available.
Inspection site visit activity started on 12 November 2019 and finished on 14 November 2019. We met with the registered manager, the deputy manager, administrative staff, care staff, and an occupational therapist. We also reviewed care records and those related to the running of the service. We carried out phone calls to people, staff and health and social care professionals involved with the service on 15, 18 and 19 November 2019.
What we did before the inspection
We reviewed information we had received about the service since its registration and we used 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. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 13 people who used the service and eight relatives about their experience of the care provided. We spoke with 15 members of staff including the registered manager, deputy manager, an occupational therapist, care workers and administrative staff responsible for co-ordinating care visits. Our contact details were made available by the service to each person receiving support and to staff to allow them to share their views about the service should they wish to do so.
We reviewed a range of records. This included six people’s care records and a sample of medicine administration records. We looked at six staff files in relation to staff recruitment and supervision. A variety of records relating to the management of the service, including staff training, meetings and safety and quality audits were reviewed.
Updated
6 December 2019
About the service
Plymouth City Council Independence@Home Reablement Service provides support with personal care to people living in their own homes. The service supports people for a period of reablement after being discharged from hospital following illness or injury. The service supports people to regain their independence with activities of daily living such as washing, dressing, meal preparation and other domestic tasks.
At the time of the inspection the service was supporting 105 people. This included a small number of people who had been assessed as requiring longer-term care and for whom alternative care provision was not yet available. The service was also supporting some people who were receiving care at the end of their life.
Not everyone who used the service received personal care throughout the period of time they were receiving support. Once people became independence with their personal care, the service supported people with domestic tasks until they are assessed as safe with these tasks, or if alternative support was required in the long-term. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People, staff and healthcare professionals told us the service was well managed. People received personalised care that promoted their independence and well-being. People told us the service focused on meeting their needs, protecting their safety and promoting their independence. People felt safe and well cared for. People’s preferences were respected, and staff were sensitive and attentive to people’s needs.
Staff were described as kind, caring and compassionate, and people said staff were well trained. Staff told us how much they enjoyed working for the service. They said they were proud of the support they provided to people and had a great sense of achievement when people regained their independence.
Risks to people’s health, safety and well-being were assessed and management plans were in place to ensure risks were mitigated as much as possible. Staff were aware of their responsibilities to safeguard people.
There were sufficient numbers of staff employed to ensure people’s needs were met. People were not provided with specific visit times but a time period, such as morning, lunchtime or evening. Staff were not restricted to a length of time they were required to be with people. As the service was a reablement service, staff spent as much time with people as needed to undertake the task people were being supported with. People and relatives told us they were happy with this arrangement. If they did require a visit at a certain time, for example, with time specific medicines or to be ready for an appointment, the service accommodated this. If staff were going to be very late, people said staff would contact them.
The service’s aim was to “enable not disable” and people were fully involved in their assessments and the development of their care plans. People discussed their progress with staff which included looking at different ways to undertake tasks or to become familiar with using equipment to make tasks safer and easier. However, not all care plans held detailed information about what people were able to do for themselves, or specific guidance for staff about how to meet people’s care needs. We discussed this with the registered manager and deputy manager who took immediate action to review and update people’s care plans, and records where necessary.
Where people were supported with their medicines, this was done safely, and people received their medicines as prescribed.
Quality assurance and governance systems were in place to assess, monitor and improve the quality and safety of the service. The registered manager maintained a service improvement plan and carried out regular audits and reviews of the service.
People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection This service was registered with us on 01/12/2018 and this is the first inspection.
Why we inspected This was a planned inspection based on the date the service registered with us.
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.