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 found the service was safe because people who received support from the service told us the staff looked after them and treated them well. One person said "The carers are all very kind to me". Another person said "All the girls are lovely". People told us they could speak with the staff or their manager if they had any concerns.
Staff we with spoke with told us that they received training in a range of health and safety areas such as moving and handling, medication awareness, and safeguarding. This meant staff were enabled to deliver care and support safely.
On the day of our inspection we met six people who were supported by the service and they looked happy and relaxed. They told us that the support they received made them feel safe and reassured. A relative we spoke with said that the support their relative received gave them peace of mind, and allowed them to go away without having to worry.
Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw comprehensive assessments of need were done before a person received support. A care and support plan then identified in detail for staff what support a person needed, when, for how long, and their preferences. We saw the manager did regular checks on medication, and spot checks were carried out to make sure care and support were being delivered safely by the staff.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards, however this does not apply to domiciliary care agencies.
Is the service effective?
This service was found to be effective because people told us that the service supported them to live their lives in a way that suited their personal needs and maintained their quality of life. Some told us that they would prefer more opportunities to go out into the community, but on the whole were very happy with the care and support provided. A relative told us 'They can really spot if things are wrong and get it sorted.' Another told us 'They have been fantastic from beginning to end, the staff have always been very efficient, and everything is done with such care, compassion, and love.'
Staff told us the provider arranged a range of relevant training and support to help them meet the needs of the people they supported. Training records confirmed what staff had said, and showed that specialist training such as for Parkinson's disease and diabetes had been delivered. People told us they felt the support helped them to maintain some independence. We saw in the policies and procedures that staff were instructed to always ask a person how much of a task they would like to do themselves.
Relatives we spoke to told us that they 'couldn't praise the support offered highly enough' and another relative told us 'I don't know what would have happened to my relative if they had not received the support they do'. People and their relatives told us that if they were unhappy with something then they felt confident they could talk to staff or the manager and it would be sorted out quickly. This showed people's views were listened to and the service was effective at dealing with any concerns or issues.
Is the service caring?
We found the service was caring. For example, we observed staff treated each person as an individual with dignity and respect. They spoke to people in a calm, re-assuring and friendly manner. People told us that all of the support staff were very kind and 'couldn't do any more to make them feel comfortable'. A relative told us that everyone in the service knew them by name and this familiarity made them feel their relative was very well cared for. Another relative told us that they 'couldn't be happier' about the care their relative received.
We saw the service had done a significant amount of work to try and support individuals with more complex care needs in order that they could remain in their own accommodation. For example, we saw records that showed support staff had undertaken some care and support tasks over and above the normal level expected, and received specialist training and support from other health professionals to achieve this.
Is the service responsive?
We found the service was responsive because people's needs were thoroughly assessed by the service before they received support, and other information, such as any health or social care assessments were also used. The manager told us most people would trial the service for two weeks and during this time a fuller assessment and care planning would take place. This meant that people had the opportunity to see if they were satisfied with the service and their needs and preferences were fully understood.
We saw that people's care was planned and delivered in line with their individual preferences. Each person's care plan was reviewed every four months, and changes made to the support needed if necessary. The manager told us people were also re-assessed if they had been in hospital for a while in case their support needs had changed.
We saw that the team manager had regular discussions with people about their support, and that relatives and carers were also invited to these. Notes of these reviews were recorded in people's care plans and were used as part of their annual care plan review. This helped ensure care and support remained appropriate to each person's individual needs.
People told us they were able to make choices regarding what time they received their support. The staff we spoke with, demonstrated a good understanding of each person's support needs and preferences and how they should be met. This meant that people were able to retain control over their daily activities.
Is the service well led?
We found the service was well led. The manager has been in post for a number of years and is currently registered with CQC.
There was a clear staffing structure in place with clear lines of reporting and accountability. Staff said they were well supported by colleagues and the provider's management. They said they could report any issues or concerns to the manager in the first instance. The manager said they were able to contact the director of the company and external health and social care professionals for advice or support whenever needed. This showed that appropriate support was available for all staff.
The quality of the service was monitored through regular personal contact with people and their representatives, audits, staff supervision, observations of staff practice, peer reviews, and annual staff and service user surveys.
We saw the provider had a comprehensive range of policies and procedures for staff to follow. The provider also provided a staff handbook containing key procedures and guidelines for staff to follow.
We reviewed a number of management documents and saw examples of clear monitoring of staff training and supervision, to ensure this was received on a regular basis.