4, 8 April 2014
During a routine inspection
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This inspection was completed by one inspector. They visited the office and three people in receipt of personal care. This is a summary of what we found based on our observations, speaking with five people who used the service or their representative, talking with three staff and looking at records.
Is the service safe?
People told us they felt safe. They were complementary about how staff supported them and described staff as polite and understanding. They were confident that if they had any concerns, the provider would listen to them and address them.
Staff knew how to recognise and report potential abuse. They were aware of which other agencies and professionals needed to be alerted to alleged abuse.
We saw that people were fully involved in the assessment of their needs and care planning. Where risks had been identified, assessments had been carried out to determine how best to manage these while supporting the person to remain as independent as possible. People were confident staff understood their needs and how to support them safely. They felt respected and in control. One person said, 'They realise I know what I'm talking about'.
Systems were in place to record accidents and incidents and these were routinely reviewed by the provider. Records demonstrated that staff had responded appropriately to incidents by summoning emergency medical support when needed.
Is the service effective?
People were given information about the service they could expect to receive. Each person we spoke with was positive about their experience of the service and were happy about the standard of care. One person said, 'They are lovely, they really are. They stay the right amount of time and do what they are supposed to do'. Another said, 'Without them I would be in a certain amount of trouble'. Records demonstrated that people's needs had been assessed and care plans agreed to meet individual needs and preferences. We saw that staff worked closely with external health and social care professionals to make sure that any specialist needs were met.
Staff demonstrated a good understanding of people's needs. New staff completed induction training which included working alongside experienced staff members while their competency and readiness to work unassisted was assessed.
Is the service caring?
During our conversations with staff they demonstrated a caring and professional approach toward the people they supported. One person's representative said, 'I'm very happy with all the people (staff) who have come. With new staff I loiter discreetly in the background and then happily leave them to it'. People described the owner as, 'Very helpful indeed' and 'Amazing'. During our inspection we saw how the owner put the needs of people who used the service first.
People we spoke with said staff were thoughtful and caring and described their experience of the service as 'comforting'. One person's representative commended staff attitude and approach toward their relative who had dementia. They said that due to dementia their relative could be 'cantankerous' at times which staff managed well and with patience.
Is the service responsive?
Care reviews were carried out at regular intervals. These included checking that care plans reflected the person's wishes and preferences about how their care was delivered. The provider discussed options open to people as their care needs and preferences changed. One person told us how when they had wanted to cancel a recent session this was agreed. Another said that if they needed anything they just needed to ring the provider and it would be organised.
People knew how to make a complaint or raise a concern. They were confident they would be listened to and the provider would resolve the matter. When people requested more information about which staff would be attending them this was sent to them each week.
Staff checked daily records before providing care to inform themselves of any recent changes. When significant changes occurred updates were sent to staff by secure email prior to attending the person's home.
Is the service well led?
Staff and people who used the service all told us that the service was well-led. One person said, 'They all know what they are doing and turn up when they say they will. It works perfectly'. Staff were enthusiastic about their work, they understood their responsibilities and said they felt listened to and supported. We found that the staff team communicated well internally and worked well with external health and social care professionals.
Systems were in place to monitor the quality of the service and to make sure that action was taken when changes were needed.