Background to this inspection
Updated
25 October 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 28 September and 03 October 2018 and was announced.
We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that a registered manager would be available.
Inspection site visit activity started on 28 September 2018 and ended on 03 October 2018. It included reviewing documentation, speaking with people who used the service and their relatives. We also spoke with staff. We visited the office location on 28 September 2018 to see the registered manager and office staff; and to review care records and policies and procedures. This was the first inspection since the service was registered.
Prior to the inspection we spoke with the local authority and we checked the information we held about this service and the service provider. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During our inspection we spoke with three people who used the service, two people who used the service but did not receive the regulated activity and two relatives. We also spoke with the registered managers, a senior support worker and two support workers.
We reviewed three people’s care records, one medication record, four staff files and records relating to the management of the service, such as quality audits and staff training.
Updated
25 October 2018
This announced comprehensive inspection took place on 28 September 2018 when we carried out a visit to the office. We also carried out telephone calls to people who used the service and their relatives on 03 October 2018.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people who may have a learning disability and associated needs.
Not everyone using HF Trust-Bedfordshire DCA receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There were two registered managers 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.
People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns.
People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.
There were sufficient staff with the correct skill mix on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.
Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.
People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.
Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.
People were able to make choices about the food and drink they had, some people were independent with this but staff gave support when required.
People were supported to access a variety of health professionals when required, including community nurses and doctors to make sure that people received additional healthcare to meet their needs.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.
People’s privacy and dignity was maintained at all times. Care plans were written in a person-centred way and were responsive to people’s needs.
People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.
Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement. People and their relatives were asked for feedback.
People are 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 support this practice.
Further information is in the detailed findings below