A single inspector 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? 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.
If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:
Is the service safe?
We saw checks had been completed by the manager around the persons own home environment. This meant that the provider where possible ensured the home was safe for both the people who used the service and the staff. The provider had developed systems to ensure potential risks were assessed and managed. Where staff had identified a potential risk, either during the initial assessment or after admission, a risk assessment had been completed to ensure people remained safe.
Is the service effective?
We spoke with the manager of the service about a person's journey from the point of referral to support being provided. They told us that an information pack about the service was sent to the person. If the person and/or their family or representative wished to proceed with the service, the manager and senior carer then visited in order to discuss the support required.
We saw before people started to use the service an assessment of needs was completed. This included an assessment of the support people required for activities and tasks such as waking and dressing, personal hygiene, communication needs and mobility.
Information gathered during the initial assessment was used to develop detailed care plans. Care plans clearly identified the goal or expected outcome of the care plan and identified the interaction and support required to achieve the goal.
We spoke with three people who used the service. One person said, 'They help me out every day. I could not manage without them." Family members we spoke with stated they were happy with how staff communicated with their relative. One relative commented, 'The care staff have a good relationship with my mother they really help out.'
Is the service caring?
People said they received good care. One person said, 'The staff are excellent."Nothing I ask of them is too much trouble.' Another person said, "The care staff treat me well."
Family members told us that staff treated their relative not only with dignity and respect but also with affection. Family members confirmed that they had seen and read their relative's care plans. "The staff are good"; "The staff seem very caring".
We looked at the care records of people who used the service. We saw people's needs had been individually assessed, and where necessary plans of care drawn up. We saw detailed information had been supplied by other agencies, such as social services. For example, we saw in one person's care plan a request by the service to increase the amount of the time spent by care staff at each visit as more support was identified. We saw this had been agreed by the local authority. This additional information was used to complement the care plans and to guide staff about how to meet people's needs. We saw formal reviews of people's care plans were held. We saw people and their relatives or representatives had been involved. This meant the risk of people receiving unsafe or inappropriate care was reduced.
Is the service responsive?
During the inspection we spoke with the care co-ordinators who told us that people got a rota each week to inform them of the times staff would be calling and who would be providing their care. Care plans were evaluated each month to ensure they remained current. The record of the review included a summary about each person's current situation. Formal reviews of care and support took place, and the person was able to decide who they wished to invite to attend. This included a relative, a social worker and an advocate. Relatives we spoke with told us, "I have come along to a review" and "I get invited to a review but they also let me know what is going on a regular basis."
Is the service well-led?
We found that the provider did not have a robust system of quality audits in place. We found no evidence that regular care plan audits together with medication audits took place.
We looked at staff records and saw staff had received regular supervisions; however staff had not received an annual appraisal within the last year.
We saw senior staff had observed staff providing care in people's homes so they could assess how they carried out their work and check they were following company policies.