North Shropshire Homecare Limited

Updated 30 January 2019

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.

We visited the service on 17 December 2018 and our inspection was announced. The members of the inspection team consisted of 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 by experience carried out phone calls to people who used the service and their relatives to collect their views of the service.

Before our inspection we reviewed all the information we held about the service, including previous inspection reports. We also examined information received by the Care Quality Commission.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with eleven people who used the service (one on the day of our site visit and ten over the telephone). We also spoke with the registered manager, an office based member of staff and five care staff.

We looked at three people's care plans and two staff files. We also looked at records relating to the management and administration of people's medicines, feedback, including quality assurance surveys.

Updated 30 January 2019

The inspection took place on 17 December 2018 and was announced. This meant we gave the provider 48 hours’ notice of our intended visit to ensure someone would be available in the office to meet us.

This service is a domiciliary care agency based in Whitchurch, Shropshire. It provides personal care and support to people living in their own homes throughout Whitchurch and surrounding areas. It provides a service to older adults with a range of health and social care needs including people living with dementia. At the time of our inspection there were 25 people receiving a personal care service.

At our last inspection of the service 4 September 2017 we found that some improvements to medicines management, recruitment and service monitoring were necessary. The service had been rated as requires improvement. At this inspection the provider demonstrated to us that improvements had been made in these areas and the service will be rated as good.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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 were safeguarded from the risk of abuse as staff were confident to recognise and report any signs of abuse. Risks were assessed and managed to keep people safe.

There were sufficient numbers of staff to meet people's needs in a safe way and the timings of calls were being reviewed to continually improve the service.

Staff received regular supervision checks to ensure they completed care visits as agreed. The provider followed safe recruitment procedures to ensure that appropriate staff were employed. Staff felt well supported and trained to carry out their role effectively and meet people’s individual needs. New staff received induction training and were accompanied and supported by the management and senior staff to enhance their induction and extend if necessary.

People's medicines were now being safely managed and administered. Improved recording systems and additional training for staff meant that staff were now clear as to their roles and remit. Risks to people were assessed and safely managed.

There were effective systems in place to reduce the risk of the spread of infection.

The provider followed the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their care and support. People’s decisions and choices were listened to and respected.

People's health and well-being was monitored and supported. People required only minimal support with eating and drinking however staff knew people’s likes and dislikes and promoted healthy eating to ensure good health

Staff interacted with people in a kind and respectful manner and they knew people well. People's privacy was respected and staff supported people to maintain their dignity. Staff had a good knowledge of people's needs. We received positive feedback regarding staff and how peoples’ needs were met.

Overall care plans were sufficiently detailed and person-centred, giving members of staff and external professionals relevant information when providing care to people who used the service. Care was reviewed regularly and some people could recall having a care review that they had been involved in. The registered manager was reviewing people's involvement.

There were effective procedures in place to respond to any concerns or complaints.

There were now a number of effective management systems in place and these monitored the quality and safety of the service provided. Although recording required further improvement, the registered manager was knowledgeable of the service’s strengths and areas where ongoing improvements were required. They were acting upon these.

People who used the service and their representatives were regularly asked for their views about their support through questionnaires and feedback forms. The registered manager also carried out care and support and used this opportunity to gather views informally.

The registered manager was aware of the requirement to notify the commission of significant events but there had not been any recently.

Further information is in the detailed findings below