Background to this inspection
Updated
28 May 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 7 April 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.
The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of caring for someone who used this type of service.
Before our inspection, we reviewed the information we held about the service and information we had received about the service from people who had contacted us. We contacted the local authority that had funding responsibility for some of the people who used the service.
We reviewed a range of records about people’s care and how the service was managed. This included eight people’s plans of care and associated documents including risk assessments. We looked at four staff files including their recruitment and training records. We also looked at documentation about the service that was given to staff and people who used the service and policies and procedures that the provider had in place. We spoke with the registered manager, and three care workers.
We contacted 24 people who used the service by telephone. We spoke with eight people who used the service and seven relatives of other people who used the service. This was to gather their views of the service being provided. The other nine people we contacted said they did not want to speak with us.
Updated
28 May 2016
The inspection took place on 7 April 2016 and was announced. The provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.
The service provided personal care to adults with a variety of needs living in their own homes. This included people living with dementia, sensory impairments, physical disabilities, older people, people with learning disabilities, and younger adults. At the time of the inspection there were 132 people using the service.
The service had a registered manager. 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 told us that they felt safe when they received care from the staff. Staff understood and practised their responsibilities for protecting people from abuse and avoidable harm. Risk assessments were in place which set out how to support people safely.
Staff were not deployed effectively. People told us that staff were often late for calls and missed calls. People told us that this made some things more difficult for them. There was a log in system in place for staff to record the time that they arrived at and left calls. This was not used by consistently by staff.
The provider had robust recruitment procedures in place. Pre-employment checks had been completed before new care workers started supporting people using the service.
People were supported to take their medicines by care workers. Staff had completed training and been deemed competent to support people with their medicines.
When people started to use the service a care plan was developed that included information about their support needs, likes, dislikes and preferences. This meant that staff had the relevant information to meet people’s needs.
People were prompted to maintain a balanced diet where they were supported with eating and drinking. People were supported to access healthcare services and staff monitored people for changes in their health and well-being.
People were supported by staff with the necessary skills, experience and training. Staff were supported through effective induction, supervision and training. The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff told us that they sought people’s consent prior to providing their care.
People told us that some staff were kind and compassionate. Staff we spoke with understood people’s needs and preferences. People were involved in decisions about their support.
People told us that staff did not always treat them and their property with dignity and respect. Some people told us that staff did not understand professional boundaries.
People were involved in the assessment of their needs.
There was a complaints procedure in place and people felt confident to raise their concerns. People told us that they had not always received a response when they raised complaints.
People had completed a questionnaire to provide feedback on the service. They were not told of any outcomes to their feedback.
People told us that they did not always receive open communication from the registered manager and the staff in the office.
Systems were in place for monitoring the quality of care and support provided. There was a log in system in place for staff to record the time that they arrived at and left calls. This was not used by consistently by staff and not monitored to make sure it was effective.
The service had a clear management structure in place and this had been restructured to make sure that service quality could be monitored more effectively. Staff told us that they found the management approachable and felt that they were listened to.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.