This was an announced inspection of Transition Care. The inspection was announced as the manager of the agency works in the community with the staff and is not always office based. The inspection set out to answer our five questions:' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. The summary is based on discussions with two people who used the services of the agency, the staff, manager and looking at care records and records related to the management of the service.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with told us they had confidence in the staff who supported them.
People and/or their families were involved in decisions about their care and support. People and/or their families were provided with the opportunity to read and sign their support plans.
The manager set the staff rotas; they took people's care needs into account when making decisions about the numbers of staff required. This helped to ensure that people's needs were always met. People we spoke with confirmed this.
In accordance with the Mental Capacity Act [2005], we saw evidence that the agency protected the rights and welfare of people. The Mental Capacity Act [2005] is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.
Is the service effective?
Care plans/support plans and risk assessments were up to date and provided guidance to staff on the support people required. Care documents reflected current care needs and included information about peoples' preferences and preferred routines. Discussions with staff showed that they understood people's support needs and how to meet these in a way the person preferred. This was confirmed when talking with people during the inspection.
Training was provided for the staff to help them support people safely and in accordance with their individual needs.
Staff were aware of the actions they should take if an emergency arose. People we spoke with informed us they knew who to contact in an emergency or 'out of hours'.
Is the service caring?
The people we spoke with told us staff were caring and polite. They also told us that staff spent time talking with them and making sure they were happy with the support provision.
A relative we spoke with supported this view and said the agency staff communicated well with them around their family member's support. Staff told us about the importance of promoting people's independence and having a supportive approach when assisting people to develop life skills.
Is the service responsive?
People we spoke with told us the staff responded promptly to their requests for support and that the staff were always available to help them.
The care documents we saw showed the staff had acted promptly in respect of supporting people with changes in their medical conditions and seeking external advice from health professionals at the appropriate time. Care documents were revised as people's needs changed.
The agency had a policy and procedure for dealing with concerns and complaints. Complaints received had been investigated and complainants responded to.
Is the service well-led?
The agency had systems in place to regularly monitor the quality and safety of the service provided; this included a number of audits [checks] which the manager completed. Records we looked at demonstrated that action plans were developed to
address identified shortfalls in a timely way.
People who used the services of the agency were provided with satisfaction surveys to provide feedback about the service provision. Meetings were also held with a number of people however the provider however may find it useful to note that there was no record of 'spot' checks being undertaken; these checks are a means of making sure the care and support the agency staff gave people in their own homes was safe and in accordance with the person's plan of care. The manager confirmed these visits would be undertaken as part of the develoopment of the agency.
Staff told us they were able to speak with the manager and their views and experience were taken into account.
The agency worked in partnership with key organisations, including the local authority and safeguarding teams to support the care provision and service development. This was evidenced through looking at a number of records and talking with the manager and staff.