1, 7 May 2014
During an inspection looking at part of the service
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records. There were 76 people using the service when we inspected.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
We spoke to eight people who used the service and relatives of a further two people. All of these people confirmed that they felt safe when being supported by care staff. One person told us: 'They are very kind staff and I feel safe with them.'
We saw and staff confirmed there was enough gloves and aprons for these to be available for staff when supporting people with their personal care. People told us that these were always used. We saw that staff had access to policies and procedures about preventing the spread of infection.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
People told us that care staff knew how to care for them and stayed for the length of time they needed to meet their needs. We spoke with care staff and looked at records. Staff had the training, experience and knowledge to provide care appropriately.
We found that although the service was identifying and monitoring when visits had not taken place within two hours of their scheduled time the number of these incidents had not reduced and this could potentially affect the safety of people. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring people's safety.
Is the service effective?
People's health and care needs had been reviewed with them. There was appropriate information in care plans in people's homes about the support they needed and how they wanted to be supported. People's comments included: "I couldn't cope with out the care given to my relative," and "I need them for my independence."
Is the service caring?
When we spoke with people and relatives their comments included: 'The staff are caring and treat me with dignity' and 'They remember my birthday and we have a chat.' All of them confirmed that staff were kind to them.
When speaking with staff it was clear that they genuinely cared and knew about the people they were supporting. People's preferences, interests, aspirations and diverse needs had been recorded and support had been provided in accordance with people's wishes.
The majority of people we spoke with had contact with the office staff who checked that the service was working well, however some did not. Some people had completed a survey about their views about the service. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring people using the service are consulted about how their needs are being met.
Is the service responsive?
People who used the service told us that they felt able to contact the office if they needed to make a complaint and the office would respond. Their comments included: "Someone always answers the phone and they are approachable," 'I have care notes in my house to show me how to complain' and "I can call the office and know I will get a good response."
One person said that they had made a complaint and the service had improved. People told us that they had always been happy with the service provided or that the service had improved. Some people said that they were waiting to see if the improvements were sustainable.
There had been problems with communication between the care staff and the office. We spoke with the staff who told us that they had attended a workshop about early warning systems and were confident that when they reported concerns about the health and welfare of people under this system that the office would respond.
Is the service well-led?
Since our last inspection the provider had increased the senior management support provided to this service. Care staff told us that the service was improving. Their comments included: 'We are pulling together more to make sure everything gets done properly. We are doing it by the book and nothing is slipshod' and 'We have had and seen more support from senior managers and it is making a difference.'
The service has a quality assurance system, and records showed problems were being identified. New systems had been put in place to improve the services ability to identify risks to people and when visits were unacceptably later than scheduled. However the occurrences of these late visits had yet to lessen. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring people's safety.