Archived: Support at Home Service

The inspection was undertaken by one inspector. This summary addresses five key questions: is the service safe; is the service effective; is the service caring; is the service responsive and is the service well led?

This summary is based on a visit to the offices where we spoke to the registered manager and some staff. We also looked at some records. Following the visit to the office we spoke on the telephone to four care staff and four people using the service or their relatives.

The full report contains the evidence to support this summary.

Is the service safe?

All the people who used the service and their relatives who we asked said that they felt safe with the care staff who visited them. Care staff told us that they had received training in safeguarding procedures and understood their responsibility to 'blow the whistle' if concerning or unsafe practices were not being addressed by their managers. Care staff told us they were confident that people using the service were safe, both with themselves and their colleagues. One member of staff told us that they believed all their colleagues were 'lovely'.

All people using the service had their needs assessed before the first support visit. This included a risk assessment which would help to identify any risks in the provision of the service and to develop strategies to reduce any risk. Staff told us they were never asked to do any tasks which they did not feel competent to undertake.

Staff told us that personal protective equipment (PPE) such as disposable gloves and aprons, were always available for them to use. The use of PPE helps to minimise the risk of cross infection.

Is the service effective?

All people using the service, or their relatives who we asked, were positive about the service provided.

We were told by the manager that everybody who received the service had their needs assessed by a senior member of staff before the service started. This enabled the service to identify anyone whose needs they could not effectively meet. The assessment also enabled an effective plan of care and support (care plan) to be developed.

All staff who we asked confirmed that there was always a written care plan available in the home of the person using the service. This was also confirmed by people using the service and their relatives. Everybody who we asked said that people using the service were involved in discussion about their care plan. They also told us people could influence the way in which their care was provided.

One member of staff said a support plan was always there, 'but you still need to communicate and ask how do you want it done?'

Staff members told us they could suggest a care plan was reviewed in the event of a person's changing circumstances. They told us their views were listened to.

The service had effective quality monitoring systems. These would help to identify if the service needed to amend any of its practices.

Is the service caring?

Everybody who used the service and their relatives, who we asked, spoke positively about the attitude of the staff who visited them. Comments included: 'the care has been excellent', 'very nice helpful girls', 'the care has been absolutely wonderful' and I just think they [staff] are good and kind'. Another person, when describing the care their relative received said 'they [staff] are very very nice and don't patronise him'.

Staff told us the support from their managers was good. Staff also told us they knew it was an expectation of the service that people were treated with respect and had their dignity maintained.

Is the service responsive?

Everybody who used the service and their relatives, who we asked, told us they were confident they could, if necessary, raise a complaint and were confident they would be listened to. One person told us that they had been told by the service that 'they must ring them' with any concern. Another person when asked if they could complain replied 'definitely'.

All the staff who we asked, told us they believed people would be listened to regarding any complaint. They also told us management listened to opinions about the need to modify any care plan and, subject to commissioning restraints, would do so.

There was a range of quality monitoring systems in place. However at the time of this inspection the service had only been running for about six months and was still growing. Consequently, although individual issues were addressed when identified, the information from the quality monitoring had not been fully integrated or analysed to inform the quality assurance part of the process. The manager told us this was planned to be addressed.

Is the service well led?

There were clear lines of accountability within the service.

There was a thorough induction period for new staff and staff were encouraged to take advantage of training opportunities. There were regular team meetings where staff were able to raise any issues. Staff understood the ethos and expectations of the service.

The process of the initial assessment of people who had been referred to the service helped to ensure that people's needs could be met by the staff team, or they would not be accepted by the service. Staff were not expected, nor requested by managers, to undertake any tasks they were not trained or competent to do.

Staff had regular supervision sessions and appraisals were planned. Managers were described by staff as open and approachable. One member of staff said 'if I needed to ask for extra [support] I could do that. I feel comfortable talking to them [managers]'.