This announced comprehensive inspection took place on 17, 21, 22 and 23 August 2017. This was the first inspection since the provider registered moved location and renewed their registration in June 2016. North Tyneside Council Domiciliary Care Agency provides personal care and support to people in their own homes via three teams; the reablement, community rehabilitation and the overnight teams. Referral into the teams follows a discharge from hospital, from intermediate care or from referrals from primary care services and generally lasts on average six weeks. Intermediate care is a care service which is a step down from hospital before a person is discharged back to their own homes. The aim of the service is to support people as they adjust back to independency in their own home. Where people are unable to carry on without ongoing support, the provider will ensure that suitable referrals are made to appropriate healthcare professionals.
The service supported 158 people who lived across the North Tyneside area, including older people living with dementia and people with physical disabilities. Due to the short term nature of this service, numbers of people being supported at any one time can fluctuate.
There was a registered manager in post. 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.
The service was well led with a dedicated registered manager in place, who was committed to providing a good service and had implemented various changes since coming into post.
Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise any concerns. Staff knew about safeguarding procedures and had received training; and we saw concerns had been reported promptly and appropriately to the local authority safeguarding teams.
People told us they had received their medicines in a timely manner, although we saw that a small number of records had not been completed fully. This was addressed immediately. The provider also was in the process of further updating their medicines policy. We have made a recommendation in this area.
Accidents and incidents were recorded and dealt with effectively by the provider. Where issues had occurred, actions had been taken and lessons learnt.
Staffing levels were maintained by timely and safe recruitment procedures when required, however, all of the current staff had worked with the provider for many years. The provider had a system in place to ensure rota allocations were monitored so people received their care ‘call’ on time and staff were kept safe. The registered manager told us they tried to ensure people were visited by the same care staff but acknowledged that this was not always possible, due to holiday, sickness or other circumstances.
Staff had received suitable inductions and completed appropriate training and development opportunities. Staff said they felt well supported by their line manager and the provider.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager was fully aware of the Mental Capacity Act 2005, particularly in relation to the court of protection.
Some people received support with eating and drinking as part of their care package. People were provided with meals they had chosen and preferred and staff ensured drinks were left between visits for people if they required them.
Staff supported people to regain or maintain their independence and treated people with extreme warmth and kindness and in a very respectful and dignified manner. Care plans and associated documents were personalised in response to the needs of individuals with the involvement of them, their family and professionals.
There was a complaints procedure in place and people and their relatives knew how to access and use it. People had no concern about complaining if they felt they needed to.