25 April 2014
During a routine inspection
Is the service safe?
People told us that they felt safe with the careworkers and that they felt staff had received training to ensure that they knew what they were doing.
Individual risk assessments were undertaken before care was delivered and care plans to address the risks were put in place to support people's safety.
Staff were able to describe what to do if they had a safeguarding concern which showed that they understood how to safeguard the people they supported. One member of staff told us they had raised a safeguarding concern about a person they cared for. During our inspection we heard the manager talk on the phone to the safeguarding team about a person they were concerned about. We saw that they logged the phone call and followed it up when they had not had a response.
There were systems in place to make sure managers and staff learned from events such as accidents and incidents, complaints, and concerns which reduced the risks to people and helped the service to continually improve. The provider had plans in place to deal with unforeseen emergencies including adverse weather.
The registered manager and coordinators were responsible for drawing up staff rotas taking into account numbers, qualifications, skills and experience required, when considering people's care needs. There was low staff turnover, which meant people and staff knew each other well. Staff were accompanied when they visited a person for the first time to ensure they understood what was required.
Care records, staff records and maintenance logs were kept up to date and were stored in a safe, secure environment.
Is the service effective?
People's health and care needs were assessed and written in care plans. People said they had been involved in writing their care plan and they reflected their current needs.
People were supported to maximise their independence over time, one relative told us "I am sure that having HomeLife has enabled my uncle to stay at home these last three years."
People told us that the careworkers helped to ensure that they took their medications at the right time. Another person told us that the careworkers were "crucial as they ensured that I can have a regular shower."
People were able to agree when a careworker visited them to suit their personal requirements. They told us that when they needed to make a change to the routine that this was also possible.
Is the service caring?
People told us "the girls are really good, they always ask if there is anything else they can do for me before they leave." Another person told us "they are always happy to make me a cup of tea even though that isn't their job."
All the people we talked to told us they were supported by kind and attentive staff. One person told us "whilst there are some that you like better than others, they are all really good." Another person told us staff had stayed longer than the allocated time on an occasion because they had had a problem.
We talked to staff, who told us that they got to know the people they cared for really well and enjoyed their visits. During visits, we observed staff talking to people in a friendly way, taking an interest in their lives and showing that they had a good knowledge of the person's preferences. Whilst they always maintained a professional attitude, they were also friendly and able to share a joke. Some people told us they really looked forward to having their visit as the careworkers provided them with important human contact.
We saw evidence that the provider had responded positively to complaints and suggestions for improvements.
Is the service responsive?
People knew how to make a complaint if they were unhappy. People told us they had not had to make a formal complaint but they felt happy to raise any concerns or issues with staff who would help to resolve them. They told us if that did not solve the issue they would also contact the manager who was always happy to help with a problem.
We spoke with the manager who told us they worked with the local authority if they felt that the care package commissioned, did not meet the person's requirements. They told us this had led to changes to the amount of time a person received. One example of this was where the initial package had designated that a person would receive a thirty minute visit each morning, but since the person had wanted to have a bath on a Wednesday, there had not been enough time in the time allocation. The senior care worker told us they had discussed this with the commissioner and agreed the time could be increased to three-quarters of an hour.
We observed the manager followed through a safeguarding issue that careworkers had brought to their attention regarding possible abuse of a person from a relative. The manager contacted the district nurses who also expressed their concern, and then also contacted the safeguarding team to alert them to the problem.
We saw evidence that people were signposted to independent advocacy services.
Is the service well-led?
The manager and senior workers worked together to ensure staff were supported to deliver care to people according to their needs. They provided support and guidance when staff had concerns.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the provider and worked to promote good relationships with all the people and other staff. This helped to ensure that people received a good quality service at all times.
Staff received regular supervision from their managers and also told us that they felt confident they would get support if they needed help. Staff were given training in addition to the mandatory training to help them support people with different needs, some of which required specialist knowledge.