Background to this inspection
Updated
14 November 2017
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 27 September 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available to speak with us.
The inspection was carried out by two adult social care inspectors 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. Our experts by experience had experience of caring for older people and people with on going health conditions.
Prior to this inspection, we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are required to be submitted by the provider to the Care Quality Commission to advise of important events. We spoke with the two local authorities who commission care from the service to gain their feedback about the care and support people received.
During the inspection we spoke with 21 people who used the service and 17 relatives. We also spoke with five care staff, a field care assessor, a member of office staff, the registered manager, the clinical services manager and the regional director. We looked at the care records of four people. We also looked at the quality audit tools and data management systems the provider used and staff records.
Updated
14 November 2017
This inspection took place on 27 September 2017. Our previous inspection carried out during January and February 2017 had found that the overall rating for the service was Required Improvement. There were breaches of Regulation with regard to person centred care, staffing and governance. At this inspection we found that improvements had been made. There were no longer breaches of Regulation and the service had made an overall improvement.
We gave 48 hours notice of the inspection as we needed to ensure that the appropriate people would be available to speak with us.
The service provides support to people in their own homes across north Suffolk and south Norfolk. At the time of our inspection the service was supporting approximately 300 people.
The service had a registered manager in place. 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.
After our previous inspection the service provided an action plan to show us how they intended to improve. They kept us regularly updated with how improvements were progressing.
The service management team had implemented a new computer based system for care planning and organising visits. This had led to improvements in the service. However, it had not been in place long enough for us to ensure that these improvements had become embedded.
People told us that the care had improved, however, there were concerns raised about the contact they had with the office. Care staff also raised concerns about the office and the lack of information on changes they received from the management team.
People were receiving the care and support they required. Staff arrived on time and stayed for the required amount of time providing the care and support people needed. Staff were aware of, and put into practise procedures to ensure people were protected from abuse.
People’s care records were written with the involvement of the person or their relative, if appropriate. They contained sufficient information to ensure that care and support was provided safely in accordance with the person’s preferences. Care records were regularly reviewed to ensure the information was up to date.
Where the service supported people with their medicines this was carried out safely and effectively.
Care staff received an induction into the service with support from senior staff members. All staff received regular training in subjects such as moving and handling and medicines. Staff received regular supervision and spot checks to ensure good practice was maintained.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Where people were supported with their nutrition systems were in place to assess and meet their needs.
The service worked to provide people with regular care staff. This supported people to build up relationships with care staff. People told us that this was a recent improvement and they were particularly appreciative of this development. They also told us that care staff were caring and compassionate.
The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.