This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger disabled adults. There were 42 people using the service at the time of our inspection.When we last visited the service on 9 and 12 October 2015 the service was meeting the regulations we looked at and was rated Good overall. However, we rated the service Requires Improvement in the key question ‘Is the service Safe?’ This was because sometimes people did not feel safe with inexperienced care staff. In addition, the provider did not always tell people when staff would be late and what time staff would arrive, or which staff would be coming.
At this inspection we rated the service Requires Improvement.
There was a registered manager in post at the time of our inspection. 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.
People experienced late visits and the provider did not always inform them staff would be arriving late. We identified these same issues at our previous inspection in 2015. This meant the provider had not improved in light of our previous inspection findings. In addition, the provider did not have an effective system to monitor the time staff cared for people and the provider had not identified the on-going issues relating to lateness which people and relatives were dissatisfied with. These issues were a breach of the regulation relating to Good Governance.
Most people and relatives we spoke with felt the service was not well-led due to the issues relating to lateness and the lack of communication from the service relating to this. People did not always know in advance who would be caring for them and some people did not receive consistency of care from the same people.
People were protected from the risk of abuse as the provider had systems in place such as training staff to recognise and respond to abuse.
Risks relating to people’s care were also reduced as the provider identified, assessed and managed risks. The provider managed people’s medicines safely.
The provider carried out recruitment checks on staff to check their suitability to care for people.
People received care in line with the Mental Capacity Act 2005 although the provider told us they would review their processes when we identified some improvements could be made.
The provider assessed and reviewed people’s care by gathering their views and consulting any relevant professional reports. People were involved in decisions regarding their care.
People were supported to maintain their health and were supported in relation to eating and drinking by staff.
Staff received suitable induction, training, supervision an annual appraisal to help them in understanding and delivering care to people. The service worked well with other services in providing care to people.
People were supported by staff who knew their needs and preferences. People were supported to be as independent as possible. Staff treated people with dignity and respect and maintained their privacy. People’s care plans contained sufficient detail about people to be reliable to staff in caring for people.
The provider had a suitable complaints procedure in place and investigated and responded appropriately to any complaints.
The service had a registered manager in post who had a good understanding of their role and responsibilities and leadership was visible and capable at all levels. The director implemented incentives to retain staff such as company cars and bonuses. The director often spoke about care-related topics at events and mentored other directors in the franchise.
The service supported people to integrate into their community by providing training to local businesses and members of the public on dementia to raise their awareness.
The registered manager encouraged open communication with people and staff and gathered their feedback on their experiences of receiving care as part of quality assurance processes. However, the provider had not used these systems to monitor and respond to the on-going issues concerning lateness.