Background to this inspection
Updated
2 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider and manager would be in the office to support the inspection.
Inspection activity started on 25 February 2020 and ended on 27 February 2020. We visited the office location on 25 February 2020 and made telephone calls to people and relatives on 27 February 2020.
What we did before the inspection
We reviewed information we received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was also asked to complete a provider information return prior to this inspection. This gives some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and used all of this information to plan our inspection.
During the inspection
During the inspection we spoke with the registered manager, deputy manager, three members of staff, three people who received personal care and two relatives. We also looked at care records belonging to three people receiving support, recruitment records for three members of staff, medication administration records and other records relating to the management and quality monitoring of the service.
Updated
2 April 2020
About the service
Stable Lives is a domiciliary care agency providing personal care to older people in South Yorkshire, Sheffield. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 12 people were receiving support.
People’s experience of using this service and what we found
Quality assurance systems were in place, although these were not always effective. Audit systems and checks were not always identifying areas of development required. People were supported to share their feedback although there was no structured system in place to review feedback, consider suggestions or implement changes that people had highlighted.
There was a complaints policy in place and although people and relatives told us they knew how to make a complaint, processes were not always in place to evidence how complaints were managed. Documentation was not robust enough; records did not contain information about how complaints were responded to.
People received person-centred care, staff were familiar with the people they supported, and positive relationships had developed between Stable Lives staff and people receiving support. End of Life care was not being provided at the time of the inspection, the registered manager agreed that this was an area of responsive care that needed development.
Medication procedures were in place; people received a safe level of support from trained members of staff. Medication audits were regularly completed to assess compliance and staff performance. We identified some minor administrative errors that needed to be reviewed; the registered manager was responsive to our feedback.
People received personal care that was tailored around their individual support needs. People’s level of risk was assessed, and measures were put in place to ensure people received the safe level of care they needed.
Safeguarding and whistleblowing processes were in place. Staff received safeguarding training; they also explained the procedures they would follow if they had any safeguarding concerns.
Staffing levels were monitored and we received feedback to suggest that people received care and support from consistent and punctual members of staff. One relative told us, “They’re [staff] the best team of carers we’ve had.” Stable Lives staff were safely recruited; although we noted that systems needed to be strengthened so that records were more organised and contained all the relevant information.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and relatives told us that kind, caring and compassionate support was provided. One person said, “They’re [staff] like family.” People were treated with dignity and respect, were supported to remain as independent as possible and were involved in the care planning process.
We received positive feedback about the management and staff team at Stable Lives. People and relatives told us that they were committed to delivering high-quality, person-centred care.
Rating at last inspection and update
The last rating for this service was ‘good’ (published 2 August 2017). The service has deteriorated to ‘requires improvement’
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We identified a breach of regulation in relation to ‘good governance’. Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.