29 May 2014
During a routine inspection
Previously, we completed an inspection in November 2013, where we found the provider was not meeting requirements for outcome 4: Care and welfare and outcome 9: Management of medicines.
After the last inspection, the provider sent us an action plan. This told us the action the provider would take to make the necessary improvements and by what date.
At this inspection we checked whether required improvements had been made since the last inspection. We also completed a combined scheduled inspection and looked at other essential standards of care.
We found that the provider had made the necessary improvements with respect to meeting people's care and welfare needs.
We found that the provider had taken a number of measures to improve systems for management of medicines. They told us that some medication records were not being completed adequately by staff. The provider told us they were aware of this and were taking action to address this.
Below is a summary of what we found. The summary is based on our observations during the inspection. We spoke with nine people who used the service and three visiting relatives. At the point of our inspection twenty-three people received a personal care service from the provider. If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
All of the people we spoke with told us they felt safe. They told us that care staff met their care and support needs and they felt safe when staff supported them in their homes.
We found that policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) were in place. This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection no applications had needed to be made.
We saw that risk management plans were up-to-date and staff said they received updates when people's needs changed. This was intended to ensure that people were not put at unnecessary risk. Policies and procedures were in place to make sure staff had information they needed so that unsafe practice was identified and people were protected.
Is the service effective?
We found that people had an individual care plan which set out their care needs. Assessments included people's needs for any equipment, mobility aids and specialist dietary requirements. This was intended to ensure that people's individual care needs were met.
People had access to a range of health care professionals some of whom visited their homes. People told us that staff helped them to access support services when needed. One person told us: 'They [care staff] supported [my relative] when they had a fall recently'. Another person told us: 'I had a fall and they [care staff] came straight away'.
Is the service caring?
We asked people who used the service for their opinions about the staff that supported them. One person told us: 'I have always been satisfied with the care. I am confident in staff hands' and another person told us: 'The care is good. I am more than happy' and: 'Staff are very caring. I am happy with the care'.
Seven out of nine people said their preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Two people told us that they felt staff were not always aware of the needs of people with hearing impairments. They told us they could not always communicate effectively with staff who supported them with their care needs in their homes.
People we spoke with told us that they felt their privacy and dignity were always respected by care staff. Two out of nine people told us that on occasions the majority of care staff on shift were male. They told us this concerned them as they did not want to be supported by male carers. Managers told us that where people specifically requested female staff, female managers would support care delivery when needed.
Is the service responsive?
We looked at examples of investigations which had been completed in line with the complaints policy. We saw that complaints were investigated and action taken as necessary. We found that systems were in place to make sure that the managers and staff learned from complaints. This reduces the risks to people and helps the service to continually improve.
People received surveys every year to give feedback to the service about care and support they received. The results of the survey demonstrated that the majority of people were very satisfied or satisfied with the care and support they received.
Is the service well-led?
We found that the service had a quality assurance system in place to ensure the quality of the service continuously improved.
Staff told us they felt supported by managers and had effective working relationships with their team.