Archived: Access to Independence

Updated 8 February 2016

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 inspection of Access to Independence took place on 7 December 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the staff would be available to speak with us.

Before the inspection visit we reviewed the information we held about the service, which included notifications submitted by the provider and spoke with the local authority contracts and safeguarding teams and with Healthwatch. This organisation represents the views of local people in how their health and social care services are provided. From the feedback we received no one reported any concerns.

Before we visited we asked the provider to complete a Provider Information Return (PIR). The PIR 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 asked for and received a list of names of people who received personal care services so that we could contact them and seek their views.

The inspection team consisted of a single inspector because the agency was small and only provided personal care to thirty-eight people.

During our visit to the agency we spoke with the registered manager and four care staff. We spoke with three people who used the service and three relatives over the telephone to seek the views and experiences of people using the service. We reviewed the records for three people who used the service. We looked at three staff files to review recruitment and training records. We checked management records including staff meeting minutes, quality assurance visits, annual surveys, the staff handbook and the Statement of Purpose. We also looked at a sample of policies and procedures including the complaints policy and the medicines policy.

Updated 8 February 2016

The inspection was carried out on 7 December 2015. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available.

At our last inspection on 5 November 2013 the provider was meeting the regulations that were assessed.

Access to Independence is a domiciliary care agency providing personal care and support to people in their own homes. The service is provided to people who live in Masham, the surrounding villages and in other areas of Yorkshire. The agency office is situated between Masham and Leyburn. There is parking available outside the office. The registered provider is Mrs Caroline Jane Cocking.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission 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

People told us they felt safe and were well supported by the agency. All staff received training in safeguarding adults and there were clear policies and procedures in place to support staff if concerns were identified.

The feedback we received from people who used the service and their relatives was very positive. We received no negative comments. People told us they had confidence in the staff and they felt safe in the way staff supported them and had confidence in the staff.

People received care and support in their own homes according to their individual needs. People told us the service was flexible and wherever possible would accommodate any changes to people’s requirements. Risks to people’s safety and welfare had been assessed and information about how to support them to manage risks were recorded in people's care plan.

The agency had systems for recording incidents and accidents and there were systems in place to support staff should an emergency occur.

Appropriate checks were made as part of the service’s recruitment process. These checks were undertaken to make sure staff were suitable to work with people who may be vulnerable.

The service provided a training programme for staff to ensure they had the knowledge and skills to support people. This included a comprehensive induction and training at the beginning of their employment, and all mandatory health and safety training. We saw systems were in place to provide staff support. Staff participated in staff meetings, and meetings with their supervisor and completed an annual appraisal. The agency had a whistleblowing policy, which was available to staff. Staff told us they would feel confident using it and that the appropriate action would be taken.

Where people needed assistance taking their medicine this was administered in a timely way by staff who had been trained to carry out this role and staff liaised with healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing.

People told us that their views and wishes were considered and that they were involved in discussions regarding their care needs. People’s care plans were reviewed to meet their changing needs. Staff told us they felt well informed about people’s needs and how to meet them.

Policies and procedures were in place covering the requirements of the Mental Capacity Act 2005 (MCA), which aims to protect people who may not have the capacity to make decisions for themselves. The MCA sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment. Staff had received training in this subject.

People described staff from the agency as kind and considerate and people told us that they were treated with dignity and respect. People told us they were always introduced to staff before they provided care on their own. Staff we spoke with told us how much they enjoyed working for the service and were committed to providing an excellent service for people.

People said they were confident in raising concerns. Each person was given a copy of the agency’s complaints procedures.

The provider had systems in place to enable people to share their opinion of the service provided and to check staff were performing their role satisfactorily.