Background to this inspection
Updated
15 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The announced inspection started on 14 November and ended on 16 November 2017. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care.
The inspection was undertaken by one inspector and an expert by experience. An expert by experience is a person who has personal experience of caring for older people and people living with dementia.
We visited the office location on 14 November 2017 to see the registered manager and office staff, and to review care records and policies and procedures.
We looked at five people’s care records, records in relation to the administration of medicine, accidents, incidents, four staff recruitment files, and audit and quality assurance and governance processes. We shadowed and spoke with two care staff completing their care calls as well as speaking with the two people they cared for. We also spoke with the nominated individual.
On the 15 and 16 November 2017 we spoke with 15 people who used the service with their permission by telephone. On the 15 November 2017 we spoke with two healthcare professionals and two relatives.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at this and other information we hold about the service. This included information from notifications the provider sent to us. A notification is information about important events which the provider is required to send to us by law. As part of our inspection planning we requested information from those organisations who commission care at the service.
Other information we looked prior to our inspection was the responses to the questionnaires we had received from those we had sent out. The responses were from 11 people (45%), 20 staff (33%), one relative and five (56%) community professionals.
Updated
15 December 2017
This inspection took place between 14 and 16 November 2017 and was announced. This service is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older people, people with a physical disability or sensory impairment, younger adults, people living with a mental health condition, dementia or sensory impairment.
At the time of our inspection there were 42 people using the service who lived in Peterborough, Oundle and the Deepings areas. The provider's head office is located on the outskirts of Peterborough.
Not everyone using Home Instead Senior Care - Peterborough, Oundle & The Deepings receives the regulated activity of personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At our last inspection on 8 December 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.
A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Staff knew what keeping people safe meant. They also knew how to report concerns and the organisations they could contact should they suspect or identify any risk to people's safety.
The registered manager had policies and procedures in place to respond to any accidents and incidents such medicines administration errors. These procedures were effective in driving improvements to help prevent any recurrences.
A robust recruitment process helped ensure that only staff who were deemed suitable due to their skills and suitable character were employed to work with people using the service.
Staff whose competence had been assessed to administer people's medicines did this in a safe way. Medicines were managed in line with current guidance.
Risks to people both in their home, and whilst out in the community had been assessed. These risks were then managed effectively to help ensure people continued to be as safe as they could possibly be. This was as well as any checks required on the equipment people used being completed to make sure it was safe to use, such as wheelchairs.
People continued to be cared for by staff who were supported, mentored, supervised and given the training and skills they needed to help each person live the life they wanted to. The support and care people received helped them to benefit by being enabled to remain as independent as possible.
People were effectively supported with their healthcare and nutritional needs. People were enabled access to healthcare support such as that from a GP in a prompt way.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were well looked after and cared for by staff who considered people's equality and any diverse needs. People rights, dignity and privacy was protected by staff.
People contributed to how the service was run, how the quality of care was maintained and how it was improved. This was by face to face meetings, observations of staff's care practises, quality assurance, audit and governance processes and staff's daily contact with people during the provision of their care. Any comments/concerns were acted upon swiftly and to the person's satisfaction.
The registered manager had created an inclusive atmosphere within the service and this had fostered an open and honest staff team culture. Staff were supported in a positive and learning environment where any poor care would be reported and acted upon immediately.
Effective governance, cooperation with other organisations and leadership by the registered manager had implemented a system of effective audit and quality assurance. Various ways to continually improve the service were sought as well up to date information about care in the community being used to better people's quality of life.
Further information is in the detailed findings below.