13, 16 June 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who lived at the home, the staff who supported them and looking at records.
Is the service caring?
We spoke with three people and a relative of one of the people who used the service. People told us that they were very happy with the service they received. One person said, "When I wasn't feeling well the carer phoned the office and they told her to stay with me until I felt better." Another person said of the care workers, "They are very helpful, very polite and I love all of them."
We spoke with three of the care workers. They confirmed that they always asked people before they delivered any care. One care worker said, "I always ask. I will say things like, "Are you ready to get washed now?" I will talk to them throughout from start to finish. I get to know that they know what I am doing and are happy with it." Another care worker said, "I ask if they are happy with what I am doing. You get to know what people want."
Is the service responsive?
People told us that they knew which care workers would provide the support for them at any time and that the care workers normally arrived on time. People told us that if their call was to be delayed for any reason the office would normally telephone them to warn them of the delay. One person said, " If they're late they usually have a very good reason." A relative told us, "Usually the office will ring and say if the carer will be late."
We saw that care plans and risk assessments were reviewed on an annual basis or more frequently if people's needs changed. The care workers told us that they assessed people's needs at each visit to ensure that the care plan in place was correct. If they noticed any change in people's physical or mental health that could affect their care needs this would be reported to the office. The senior care worker would then visit to review people's needs. Similarly, when people were admitted to hospital their needs would be reassessed on their discharge home.
We saw that the service conducted periodic telephone checks with people who used the service and their relatives. This was to obtain their views as to the quality of the service that was provided. These telephone calls had been completed by the manager, senior care worker and the locality manager for the service. We noted that the responses from these telephone calls had generally been very positive. We saw that when one person had expressed their dissatisfaction with one care worker the manager had discussed these with the care worker and arranged for an alternative care worker to attend the person's calls.
Is the service safe?
Care was planned and delivered in a way that was intended to ensure people's safety and welfare. The care plans were supported by detailed risk assessments that identified the hazard, who was at risk, the controls that were in place and further action that should be taken. The risk assessments included people's environment, moving and handling and the administration of medicines.
We spoke with three people and the relative of one person who used the service. They told us that they felt safe with the care workers when they were in their home. One person told us, "I feel safe with them." Another person said, "I am very safe with the people in my home."
We saw that the service had an up to date policy on the safeguarding of vulnerable adults. The contact details for the relevant local authority safeguarding teams were clearly displayed on the noticeboard in the office shared by the manager, senior care worker and the service administrator.
We spoke with three care workers. Two care workers who had recently started work with the service told us that they had received training on the safeguarding of vulnerable adults during their induction training. The third care worker told us that they had received refresher training on an annual basis. The care workers were able to demonstrate a good awareness of the types of abuse that could occur.
During our inspection we looked at four staff recruitment files to check whether robust procedures were in place to safeguard people who used the service. We found that there were robust recruitment procedures in place.
Is the service effective?
We looked at the care records of six people who used the service. We saw that people had signed forms that agreed to the terms and conditions of service. The records also contained documentation, signed by the person who used the service or a relative on their behalf, that confirmed that they had been involved in the development of their support plan and consented to the care provided in accordance with it. There were also signed consent for medicines administration and for Housing 21 care workers to use the key safe, where this was appropriate, to gain access to their home.
Is the service well led?
The registered manager told us that they were acting as an interim manager, although they have registered with the CQC, until a permanent replacement manager could be found. They were the Business Support Manager for the organisation.
We looked at the personal records of four care workers. We saw that these contained records of spot checks and observations that had been completed by the senior care worker and discussions that had been held with the manager about any shortcomings. We noted that one spot check had identified that the care worker had failed to wear their identification badge and this had been brought to their attention.
We saw that the senior care worker and the manager carried out a number of quality audits. These included an audit of the documentation in people's care records, both held at the office and in people's homes, and of the medicines administration records.