Background to this inspection
Updated
17 January 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 checked 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 25, 26 and 29 September and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service.
The inspection was carried out by one inspector and two experts by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Both experts by experience had experience of supporting people with learning disabilities.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We sent out surveys to people, people’s relatives and health and social care professionals involved with the service. We reviewed information we held about the service. We looked at notifications received by the Care Quality Commission (CQC). A notification is information about important events which the provider is required to send us by law, such as a serious injury.
The inspection visit was carried out over three days. The inspector and one expert by experience visited and spoke with seven people in their own homes and two visiting relatives. The other expert by experience spoke with two people, one relative and seven staff who were supporting people in their homes, over the telephone. The inspector spent time in the office over two days, talking to the registered manager and four staff in the management team, looking at assessments and care plans and checking records. We looked at eight staff files and eight care plans.
Updated
17 January 2018
This inspection took place on 25, 26 and 29 September 2017 and was announced.
The service provides care and support to people living in their own homes.
The service was last inspected in June 2016 and was rated as ‘Requires Improvement’ overall and in each of the five domains. At that inspection, we found breaches of Health and Social Care Act Regulations relating to dignity, respect and privacy, the lack of actions to properly mitigate some known risks to people and insufficient training for staff in some key areas. We issued requirement notices about these issues and asked the provider to make the necessary improvements.
We also served two Warning Notices about breaches of Regulation relating to care planning and the need to seek and act on people’s views. Actions arising from auditing had not been consistently effective in addressing any shortfalls in the safety and quality of the service.
Following our last inspection the provider sent us an action plan. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. At this inspection we found improvements had been made and the breaches of Regulation were now resolved, with both Requirement actions and Warning Notices now met.
Risks to people, including those associated with medicines, had been properly assessed and actions to reduce risks were taken in practice. Staff understood their responsibility to keep people safe and to report any concerns in this regard. People’s medicines were managed safely
There were enough staff deployed to meet people’s needs and training had increased and improved. Safe recruitment practices were in operation.
Staff received effective supervision and training that was relevant to the people they supported. They understood and applied the principles of the Mental Capacity Act (MCA) 2005 and verbal consent was sought from people when support was offered.
People’s health care needs, including around nutrition were assessed, monitored and supported. Staff were respectful, courteous and were mindful of people’s right to privacy. Independence and choice were promoted by staff so that people could live their lives as they wished.
Care planning was person-centred and took into account people’s preferences and chosen routines. A range of activities were supported by staff and people said they enjoyed these. There was an effective complaints process in place and people and relatives knew how to raise concerns. There was evidence of improvements made as a result of complaints.
Leadership and oversight had improved. Auditing and checks were used to identify any shortfalls in quality and safety so they could be addressed. Feedback was sought in a variety of ways and people and relatives told us the management team were approachable.