8 July 2014
During a routine inspection
On the day of our inspection 120 people used the service. We visited four people who use the service in their own homes, and spoke with a further four people by telephone. We also spoke with five people's relatives, eight care workers, two senior care workers, the person managing the service at the time of our inspection, the care coordinator and the provider's quality manager.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register for this service at that time. The quality manager explained the actions the provider was taking to employ a registered manager for this service.
The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we were told, what we observed and the records we looked at.
Is the service caring?
People told us care workers were caring. One person told us that while they had been feeling unwell 'They've been in to check that I'm ok'. Another person told us 'They are very good, polite and helpful', and a relative said 'The caring is good'.
We observed a senior care worker on visits to two people in their homes. Their manner was reassuring, respectful and friendly. They ensured the person was relaxed and comfortable with them. They knew the individuals, and chatted with them about their interests. They ensured they understood the person's needs and wishes, and that this was reflected in their care plan. This meant the service treated people with care and respect.
Is the service responsive?
We found the service was responsive to people's needs. We looked at eight people's care plans. They all contained an initial assessment of the person's needs. This identified any health issues that may impact on the care people required, and provided guidance for care workers to ensure people's needs were met.
We saw senior care workers regularly reviewed people's care plans with them, to ensure their needs were met to their satisfaction. We noted information had been updated to reflect people's changing needs. For example, when one person had been discharged from hospital, we saw that the senior care worker had checked that their care plan matched their current needs. One care worker told us 'We sit down, and I talk it [the care plan] through with them. I explain what it means, and ensure it has everything they want in it'. This meant the service was responsive to people's needs.
Is the service safe?
We found the service followed safe practices. Risks that may affect the health or wellbeing of people or care workers had been identified and assessed. We saw staff had been provided with guidance and training to promote safety.
The service ensured people's personal information was securely stored, and only those authorised to do so could access confidential data. We observed offices containing information about people and staff were kept locked or manned throughout our visit. People and staff told us they were confident that the service stored and used information about them appropriately.
Is the service effective?
We found the service had effective processes in place. One person told us 'They are always here, no matter what. Staff go out of their way to help. I couldn't get better support'. Another person told us 'I have nothing but praise for them. I went from short term to long term care with them. We've settled into a really good routine, with a consistency of care. I can't think of anything I'm not happy with'.
Some people and care workers told us that at times the service had struggled to deliver visits at the agreed times. The quality manager told us that they had taken measures to improve identified concerns, including the recruitment of additional care workers and improved monitoring of visit times. We saw evidence that these actions were in hand. This meant that they had put procedures in place to effectively address identified concerns.
Is the service well led?
We found the service was well led. A management structure was in place to support people and monitor people's care provision. All the people and relatives we spoke with were complimentary about the care and support they received. They told us staff regularly checked that the care provided met their needs and wishes. We saw this reflected in reviews and updates to people's care plans.
One care worker told us 'Senior staff are fantastic, they help us as much as they can'. All staff understood reporting processes, and who to contact should they require support or guidance. They understood their roles and responsibilities. One care worker told us 'They know where they're heading and how they will get there. It's about quality of service, not quantity'.
The management and provider undertook audits, checks and reviews to analyse information recorded, such as accidents, incidents and complaints. They had implemented changes identified from the information collated. This meant the service identified issues and took actions to reduce the risk of repetition, and demonstrated that the service was well led.