13 December 2016
During a routine inspection
This inspection took place on 13 December 2016 and was announced which meant the provider was given short notice of the inspection. This was because the location provides a supported living service to people in their own homes. We wanted to make sure the provider would be available to support our inspection, or someone who could act on their behalf.
There was a registered manager in post at the service. 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.
During our inspection we saw that an emergency hoisting procedure was being used by staff outside of an emergency situation. The person’s risk assessment stated there always needed to be two members of staff to use the hoist to move the person safely, unless in an emergency. There was no other risk assessment to show this practice had been reviewed as safe, outside of an emergency situation. The management team were proactive in addressing this concern. They provided confirmation after the inspection that the appropriate action had been taken to safely undertake this manoeuvre.
During our inspection we saw that one person’s medicine administration record (MAR) had been handwritten. The agency’s procedure of two staff members counter signing any handwritten amendments on a MAR had not been followed. We saw that all other medicine administration and storage was managed safely.
People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. One staff member said “We do everything, it’s all up to date, [X] (team manager) always knows when training is due and we can do things you may want to do”. All the staff were either NVQ Level two trained or in the process of completing the course.
The relationships between staff and people receiving support demonstrated dignity and respect at all times. Staff knew, understood and responded to each person’s physical, social and emotional needs in a caring and compassionate way. One relative told us “Everything is fantastic, [X] loves his keyworkers, they are really good”. We observed staff interactions with people and saw that staff were caring and attentive to the people they supported.
People were able to choose what activities they took part in and maintain hobbies and interests which staff provided support for as required. One person said “If we want to go somewhere we tell staff”. Staff knew people well and what kind of things they liked to participate in. Staff worked hard to engage people in their chosen activities.
People told us they felt confident in the management team commenting “I talk to [X] (team manager) if I have any concerns” and “It’s a good service, I get on with most staff”. Staff spoke highly of the team manager and registered manager saying “The team manager has been the best we have ever had. Anytime I have a problem you can go to her and you feel comfortable with her” and “[X] (registered manager) is always around and we are getting to know her more than any of the others we have had, she’s very approachable”.
Quality assurance systems were in place to monitor the quality of service being delivered. Monthly manager checks were completed in people’s homes of the paperwork staff completed including people’s medicine administration records and daily notes. The quality assurance team used an online spread sheet that managers updated with information including support plan reviews and one to one meetings.