Background to this inspection
Updated
19 March 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector and an assistant inspector.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people living in their own homes up to 24 hours per day. This included multiple supported living settings, where up to four people shared accommodation. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and their wider social support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 48 hours' notice of the inspection visit because the service provides a domiciliary care service and we had to make sure staff would be in.
Inspection activity started on 18 February 2019 and ended on 19 February 2019. We visited the office location on 18 February 2019 to see the registered manager and to review care records and policies and procedures. We visited four people at their homes, with prior permission, and spoke to staff on 18 February 2019. We spoke to the registered manager and nominated individual via the telephone on 19 February 2019. We reviewed post-inspection information on 19 February 2019.
What we did:
We used information the provider sent us in the Provider Information Return. 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 play to make. We also reviewed the information that we held about the service. This included any statutory notifications received. Statutory notifications are specific pieces of information about events that happen within the service, which the provider is required to send to us by law.
We sought feedback from the local authority contracts monitoring and safeguarding adults' teams, and reviewed the information they provided. We contacted the NHS Clinical Commission Group (CCG), who commission services from the provider. We also contacted Healthwatch, who are the independent consumer champion for people who use health and social care services. We used the feedback gathered from these parties to inform our inspection and judgements.
During the inspection, we reviewed the care records for two people receiving the related activity and the recruitment records for two members of staff. We reviewed policies, procedures, audits and records relating to how the service is run.
After our inspection, we requested additional information to be sent to us. The was received and the information was used as part of our inspection.
Updated
19 March 2019
About the service: Gateshead Council Supported Living Domiciliary Care Service is a domiciliary care agency. It provides personal care and support to people living in their own homes. It provides a service to a range of people including those living with learning and physical. At the time of inspection there were 14 people receiving the regulated activity of personal care throughout Gateshead.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
People’s experience of using this service:
People received person-centred care which met all of their assessed needs. People had detailed and individual care plans which were regularly reviewed and updated as people’s needs changed. Risk assessments were in place to help keep people safe by mitigating identified risks people faced.
There was a governance framework in place to assess the quality and safety of care provided to people. We found this framework was not always effective as the registered manager had not notified the Commission of two incidents. The service was operating a supported living model of care and not a domiciliary service to people. We are dealing with this outside of the inspection process.
Staff were kind and caring with people and respected their privacy and dignity. People received safe care from a well established staff team who had received all mandatory training and on-going support.
Medicines were safely managed. Staff supported people with their medication appropriately and worked in partnership with GPs and other health care professionals to regularly review people’s medication and assess their needs.
Staff demonstrated a good knowledge of people and their relatives. People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.
People were supported to be independent, maintain social relationships and supported to attend activities that they had chosen in the community.
Staff worked in partnership with other health care professionals and used best practice guidance.
More information is in the detailed findings below.
We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around the governance of the service and not displaying previous ratings of the provider’s services on their website and the registration of the service. We also found a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 due to the registered manager not notifying the Commission of a serious injury and a safeguarding incident. Details of action we have asked the provider to take can be found at the end of this report.
Rating at last inspection: At our last inspection the service was rated good. Our last inspection report was published on 8 September 2016.
Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found the service continued to be good in most areas. However, we also identified some areas which required improvement.
Follow up: We will continue to monitor the service through information we receive from the service, provider, the public and partnership agencies. We will re-visit the service in-line with our inspection programme. If we receive any concerning information we may inspect sooner.