This inspection took place on 25 and 26 February 2016 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available to speak with us.The service provides personal care to people who live in their own homes. At the time of the inspection there were 26 people receiving the regulated activity of personal care including five people who received a supported living service.
There was no registered manager in post though the manager had submitted their application to register with us. 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.
The service did not always act in accordance with the Mental Capacity Act 2005 to ensure that people were supported to make their own decisions or that decisions were made in their best interest when they were unable to do so. This meant that people's legal and human rights may not always be upheld.
Quality assurance systems were not always effective to ensure that issues with quality were identified and acted upon in order to drive continuous improvement.
These issues resulted in breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
People felt safe and staff understood their responsibilities to keep people safe where abuse may be suspected.
People's risks were assessed. Clear and specific risk assessments and management plans were in place which staff were aware of and followed to ensure people were safely supported.
There were enough suitably qualified staff available to meet people's assessed needs and safe recruitment practices had been followed. We found that people received support with their medicines when required.
Staff received training and supervision which ensured they had the knowledge and skills required to meet people's needs. People were supported to eat and drink sufficient amounts and staff encouraged people to make choices about their eating and drinking.
People were supported to access health professionals and referrals for advice were sought by staff, which ensured people's health and wellbeing was maintained.
People received care that was caring and compassionate and they were enabled to make choices about their care. People's dignity was maintained when they received support from staff.
People were involved in the planning and review of their care, which was planned and carried out in a way that met their preferences. Staff knew people well and their care plans contained detailed information about the way they preferred to be supported.
People told us they knew how to complain and the provider had an effective system in place to investigate and respond to complaints.
Some staff did not feel supported by the management at the service though there were plans in place to address this.
The service worked in partnership with key agencies to help ensure that people received holistic support.