Background to this inspection
Updated
29 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 checked 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.
This inspection took place between 2 and 13 November and was announced.
We gave the service 48 hours’ notice of the inspection visit because we asked registered manager to make arrangements for us to be able to call people. We also wanted to visit the office, talk with staff and review records.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults.
The inspection team included one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was in the care of older people.
Before the inspection we looked at all of the key information we held about the service, this included whether any statutory notifications had been submitted. Notifications are changes, events or incidents that providers must tell us about; no notifications had been submitted. The inspection was also informed by feedback from questionnaires completed by a number of people using services, their relatives, staff and community professionals who had experience of working with the service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We also checked what information Healthwatch Derbyshire had received on the service. Healthwatch Derbyshire is an independent organisation that represents people using health and social care services.
In addition, during our inspection we spoke with eleven people who used the service and eight relatives of people who used the service on the telephone. We also spoke with the registered manager, two domiciliary care organisers who had responsibility for organising peoples care and three care assistants.
We looked at three people’s care plans and reviewed other records relating to the care people received and how the agency was managed. This included risk assessments, quality assurance checks, staff training and recruitment records.
Updated
29 December 2017
This inspection took place over 2, 3, 6, 8 and 13 November 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk with staff and review records. Telephone calls to people were completed on 2, 3 and 8 November 2017. Telephone calls to staff were made on 13 November 2017. We visited the office on 6 November 2017.
At our previous inspection in July 2016, we found one breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to complete an action plan to show what they would do and by when to improve the key question, ‘How are people’s medicines managed so they receive them safely.’ At this inspection we found improvements had been made.
This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults, in and around the high peak area of Derbyshire. Not everyone using Cromwell House (DCC Homecare Service) receives regulated activity; 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. The provider informed us 99 people received support with their personal care needs.
The service is required to have a registered manager. 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. At the time of our inspection there was a registered manager in post.
People were kept safe and the risk of abuse was minimised because the provider had systems in place to recognise and respond to allegations or incidents. Other risks were assessed and actions taken to reduce known risks. Pre-employment checks were completed on staff to check their suitability for the role. Sufficient numbers of staff were available to care for people and further recruitment was planned to keep staffing levels sustainable. Medicines were managed safely and practices were in place to prevent and control any infections.
People made decisions in relation to their care and support; where they needed support to make decisions their rights were protected under the Mental Capacity Act 2005. People understood their care and support because they received information in a format that met their needs.
Staff received training in areas relevant to people’s needs and received support through supervision meetings. People’s health and any associated risks were monitored and responded to; referrals to other healthcare services were made where this would be of benefit. Where staff provided care with people’s meals, this was done in a way to help people maintain a balanced diet.
People were cared for by care staff who were kind and caring. Care staff respected people’s privacy and dignity. People were supported with their independence by staff who understood how important this was for people’s wellbeing.
People were involved in decisions, as well in the planning of their care and support. Staff were aware of people’s interests, hobbies and preferences. Assessment of people’s diverse needs, including in relation to protected characteristics under the Equality Act were considered in people’s care plans with them. This helped to ensure people did not experience any discrimination.
People knew how to raise issues and where they had done so these had been investigated and people had received a response.
A registered manager was in place and they understood their responsibilities for the management and governance of the service. Systems were in place to monitor and improve the quality of the service provided. The service was focussed of achieving good quality outcomes for people. The service was managed with an open and transparent culture where people were listened to and staff were valued.