Archived: In Home Care Ltd

Updated 19 June 2018

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 25 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection team consisted of two inspectors 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.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information contained within the provider's website.

We spoke with 23 people by telephone. We spoke with four care staff, the registered manager, deputy manager and the trainer. We reviewed six people's care records, which included their assessments, care plans and risk assessments. We looked at six staff recruitment files, supervision logs and training plans.

We examined the provider's records, which demonstrated how people's care reviews, staff supervisions, appraisals and required training were arranged. We also looked at the provider's policies, procedures and other records relating to the management of the service, such as staff rotas, health and safety audits, medicine management audits, and minutes of staff meetings. We considered how people, relatives and staff members comments were used to drive improvements in the service.

Updated 19 June 2018

The inspection took place on 25 April 2018 and was announced, this was to ensure staff we needed to speak with were available. This was the first inspection due to the service being new so we could not gather any information from past reports.

In Home Care Limited is a domiciliary care agency; it provides personal care to people living in their own houses and flats. It provides a service to older and younger adults who may be living with a physical disability, a mental health condition, a learning disability or people living with dementia. At the time of the inspection, 46 people were 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.

There were policies and procedures in place to protect people from risks to their safety and welfare; this included the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely and where there were any short falls these were covered internally.

The provider had an effective recruitment process to make sure the staff they employed were suitable to work in a care setting.

Risks to people were assessed and action was taken to minimise any avoidable harm to people. Staff were trained to support people with an array of health care needs, in line with recognised best practice.

Where people required support to help them manage their medicines, this was done so safely and staff were well trained in medicine management.

People were protected from the risk of infection as staff underwent training and followed the guidance provided.

There were procedures in place so that staff could raise any concerns with regard to safety incidents, concerns and near misses, and how to report them internally and externally, where required. The registered manager analysed incidents and accidents to minimise the risk of similar incidents happening in the future.

People's needs had been assessed and they had a written care plan to meet their identified needs.

People were supported by staff who had the required skills and training to meet their needs. Where required, staff completed additional training to meet individual’s needs. There were no people at the time of inspection that required support with food or fluid intake.

The registered manager involved a range of external health and social care professionals in the care of people, such as: community nurses, social workers and GPs to enable them to be supported to live healthier lives.

The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. 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 service did not currently support any individuals who required assessments under the MCA.

People experienced consistency of care from staff who were kind and compassionate. People we spoke with told us the staff were very caring and kind. People told us they were involved in making decisions about their care and that their wishes were respected. Staff ensured people's privacy and dignity was upheld at all times.

The service was responsive and involved people in developing their care plans which were detailed and personalised to ensure their individual preferences were known. People's care plans had information about people’s care needs, as well as their wishes regarding independence and any risks identified and how to minimise these. If a person’s needs changed then their care plans were updated.

Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

The service was well managed and well-led by the registered manager who provided clear and direct leadership, which inspired staff to provide good quality care. The safety and quality of the support people received was effectively monitored and any identified shortfalls were acted upon to drive improvement of the service.