We carried out this inspection because we had received concerns about the service.We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, the staff supporting them and looking at records. We also spoke with the registered manager.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
During our visit we met one person who used the service and spoke with the representatives of three others. We did this because the people who received personal care from the service could not share their views verbally with us. Everyone we spoke with said that their relative was safe and well looked after. They told us how they worked with the staff team to plan and review the service.
We spoke with staff who supported people who used the service and with team managers and the registered manager. They all told us they had the skills and knowledge to offer effective and consistent support.
We saw very detailed care plans were in place to identify how people's needs should be met. Risk assessments supported activities and staff told us how they assessed how people were feeling before any planned activity went ahead. This meant they could reschedule if they had any concerns about how people would cope with it.
We found that there was confusion around some staff roles and responsibilities and this had negatively impacted upon the quality of the service provided. The policy to support professional boundaries was not being followed although staff told us that they were aware of it. This meant that people who received a service could not be clear about what support they could and could not expect.
Is the service effective?
We saw how the service had been developed around the needs of the people they supported. People's health and care needs were assessed with the full involvement of relative and advocates when appropriate. This meant that people's care and support needs could be met in ways that people preferred.
We saw records of how the agency worked with health and social care professionals as required. This meant they could be sure that they were providing consistent care and support.
Everyone that we spoke with was satisfied with the service that their relatives received. One relative told us, "I am extremely satisfied".
Is the service caring?
People who used the service were supported by staff who cared about them. We heard staff speak with people in a calm and reassuring way. They responded to requests for support in a timely manner. Staff told us how they supported people to make choices while not raising their anxiety levels. One relative told us, 'The staff are brilliant. They are all so kind.'
Is the service responsive?
We saw how staff responded to people's changing needs. We saw that they worked with health professionals and relatives to ensure that people's needs were met consistently and appropriately.
We saw the registered manager had taken action when issues had been brought to their attention however the lack of regular monitoring of the service meant that they had not identified issues themselves and so not taken prompt action to reassure and support people who used the service.
Is the service well-led?
People who used the service lived in their own homes with varying levels of support. Some people required a high level of support to meet their personal care needs. These people were supported by a staff team that was managed by an onsite manager. Staff told us that these managers were effective and supportive. Some staff told us the registered manager was supportive however not all staff who worked for the service thought so. A lack of regular visits to services to assess and monitor the quality of the service provided meant that issues had not been identified and managed until they impacted upon people's quality of life. The registered manager had not worked effectively with social care professionals in relation to investigating concerns about the behaviour of named staff who worked for the service. They had not put sufficient safeguards in place to protect staff as professional boundaries were unclear.