An inspector for adult social care carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?As part of this inspection we spoke with 12 people who used the service or their family members if they found it difficult to communicate on the telephone. We also spoke to the owner, the registered manager and six other members of staff. We reviewed records relating to the management of the service which included six sets of care records, staff records and quality assurance survey results.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
Risks to people using the service were assessed. Staff had guidance and training for safely assisting people with mobility difficulties. They also had training and equipment (such as gloves and aprons) to ensure people were protected from the spread of infection and people needing assistance confirmed that staff used it.
Recruitment procedures were not wholly robust and thorough. Although background checks were made to ensure people were not barred from working with vulnerable adults, the interview process did not routinely provide for exploring the skills, experience and full employment histories of prospective employees. In addition, there was inadequate accounting for any issues to ensure there were no concerns for people's safety in respect of unsuitable members of staff. We have asked the provider to tell us what they are going to do to improve the effectiveness of their recruitment procedures.
We received positive comments from people about staff. For example, one person said, "I feel safe. I couldn't fault them at all. I couldn't have anyone better. They really are top rate."
Is the service effective?
People's health and care needs were assessed with them or their relatives if they found this difficult because of confusion or communication difficulties. People told us they were involved in developing their plans of care and staff provided the support they needed.
Staff received supervision, appraisal and training to make sure they were able to meet people's needs effectively. Staff were able to tell us about someone's needs and the information they gave us matched with the person's care plan and information from their relative. This showed that staff understood what was expected of them to promote people's health and welfare.
Is the service caring?
People using the service or their relatives told us that staff were caring and kind in their approach. One relative told us that that staff always asked, "Is it okay to do this?" They felt that staff asked permission about doing things, involved the person and told us, "That makes you feel more than human." Another said, "They speak to us really nicely. They're like friends some of them, they're all great." One person commented, "They're all civilised and listen to what I think. They're very polite. We laugh and joke but they don't overstep the mark."
People felt that they were given sufficient time during staff visits for their needs to be met and for them to do what they could for themselves without being rushed. The agency does not take contracts for 15 minute visits. All visits are a minimum of half an hour to allow for staff to meet people's needs properly.
Is the service responsive?
People told us that, where they had needed to raise any issues about their care or about staff, the management team responded to these. They also told us that staff always checked if there was anything else that needed doing before they concluded their visit. Where staff had raised concerns about people's welfare or safety, the manager took prompt action to secure additional advice or equipment. A relative also told us that staff were quick to spot when someone's health changed and to ensure that medical advice was taken as and when required.
Is the service well-led?
There were assessments of risks relating to the delivery of care, including any risks posed to staff working in people's own homes. These were documented and recorded to ensure they were minimised. Staff felt that they could raise suggestions for improvement and any concerns with the management team. People using the service also described the office staff as approachable if they had any issues.
There was a quality assurance system which provided for consulting with people and their relatives. Where shortfalls or concerns were identified, these were addressed promptly. People told us that, if they had needed to raise any concerns, these were dealt with promptly so that the service was improved. Senior staff, including the manager, were involved in spot checks on staff to make sure they were carrying out their duties as expected and so any shortfalls could be addressed.