20 January 2017
During a routine inspection
The people who used the service were either unable to talk to us or preferred not to speak to an inspector however we did ask their relatives or legal representatives for their opinions on the care provided. People were said to be very happy with the service and their relatives or representatives told us that the service made them feel safe.
Staff had a firm understanding of how to keep people safe and there were appropriate arrangements in place to manage risks. There were enough staff employed to care for people safely and the provider had robust recruitment procedures to ensure that staff were suitable to work with people. People were supported to receive their medicines safely in line with current regulations and guidance.
Staff told us they had received training and were confident to meet people’s needs. Staff were happy with the level of support they received and told us that communication with senior staff was good. One care worker said, “Providing live-in care is different to what I have done before. It can be challenging but I have access to support all the time.” People’s relatives and representatives told us that they had confidence in the staff. One relative said, “I have absolute trust in them.” Staff had a firm understanding of the responsibilities with regard to the Mental Capacity Act 2005 (MCA). Records confirmed that where people lacked capacity to make specific decisions the service was guided by the principles of the MCA to ensure any decisions were made in the person’s best interests.
People were supported to have enough to eat and drink. Care plans guided staff in offering people choices and risks of dehydration or malnutrition were assessed and monitored. Staff were proactive in supporting people to have access to health care services when they needed them. One relative said, “My relation finds dealing with medical practitioners difficult and the care worker has liaised with them wonderfully.” Staff told us they knew people well and recognised if they were unwell.
Staff told us they had developed positive relationships with the people they were caring for. One care worker said, “I have had to take things slowly and we have developed trust over time.” People’s relatives and representatives spoke highly of the caring nature of the staff. Their comments included, “The care had been exceptional,” and “They are incredibly kind and always cheerful.” Staff had a firm understanding of how to protect people’s privacy and maintain their dignity. People were involved in planning their care. A relative said, “They met with my relation and discussed their needs and expectations and asked what they required.”
Care plans were personalised and detailed. They guided staff in how people wanted their care to be provided. Staff were responsive to changes in people’s needs. A health care professional told us, “It is a very person-centred service.” Staff were able to support people to maintain relationships and to follow interests, for example by accompanying people on outings. One care worker told us, “It’s important to keep them occupied with interests that stimulate them.”
The provider had a complaints system in place but had received no complaints. People’s relatives and representatives told us there was regular contact with the provider and they confirmed that any issues raised were dealt with appropriately. One relative said the registered manager was, “Quick to resolve any problems.” The provider had processes to collect feedback from people, their relatives and representatives as well as health care professionals and their own staff. They described an open culture where views were welcomed to drive improvements in the service. There were systems and processes in place to monitor the provision care.
The office was based in Brighton but people received care in their own homes which were in London, Surrey and Sussex. Staff had made links with local communities where people lived such as a hospice local to one person. Staff, relatives and representatives spoke highly of the registered manager. They were described as “ Easy to talk to,” “Incredibly kind,” and “Helpful, professional and reliable.” There was clear leadership and staff were clear about their roles and responsibilities. The ethos of the service was about “Putting the clients at the centre of everything we do.” Staff had a clear understanding of this and had embedded the principles of person centred care within their practice.