The inspection took place on 29 April 2016 and was announced. We gave the provider 48 hours notice of our visit because we wanted to ensure they were available to support the inspection.Grace At Home Limited provides care and support to people in their own homes. The service provided personal care to seven people at the time of our inspection.
Sandra Findlater is registered with the CQC as the Responsible Individual for the provision of personal care. A Responsible Individual is a person who has the legal responsibility for meeting the requirements of the law. Sandra Findlater manages the service on a day-to-day basis and is referred to in this report as ‘the provider’.
People felt safe when staff provided their care because their care workers understood their needs and any risks involved in their care. Relatives were confident their family members were safe when receiving their care. People told us that they could rely on their care workers. They said their care workers had never missed a visit and the agency contacted them to let them know if a care worker was running late. The provider had identified those people most at risk if their care was interrupted and had developed plans to prioritise the delivery of their care in the event of an emergency.
Staff received training in safeguarding and recognising the signs of abuse. The provider carried out risk assessments to ensure that people receiving care and the staff supporting them were kept safe. Where an incident or accident had occurred, there was a record of how the event had occurred and what action could be taken to be taken to prevent a recurrence. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the service.
People received their care from regular care workers who knew their needs well. New care workers were always introduced to people by the provider before they began to provide their care.
The provider understood the importance people placed on having regular care workers and ensured people received a consistent service from familiar staff.
Staff had access to the training and support they needed to fulfil their roles. All staff attended an induction when they joined the agency and shadowed experienced colleagues until the provider was confident in their ability to provide people’s care safely and effectively.
The agency worked co-operatively with people’s families to ensure they received the care they needed. Relatives told us staff were observant of any changes in their family member’s needs and said the provider contacted them if they had any concerns about people’s health or welfare.
People’s nutritional needs were assessed during their initial assessment and any dietary needs recorded in their care plans. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required.
People were supported by kind and caring staff. People told us their care workers were polite, courteous and treated them and their property with respect. They said they had developed good relationships with their care workers and looked forward to their visits. Relatives told us that care workers were compassionate and sensitive to their family members’ needs. They said staff knew how their family members preferred their care to be provided and genuinely cared about their welfare.
People received a service that was responsive to their individual needs. The provider assessed people’s needs before they began to use the service to ensure the agency could provide the care they needed. People were encouraged to be involved in the development of their care plans and the provider reviewed plans regularly to ensure they continued to reflect people’s needs. Relatives told us their family member’s care plans had been developed in a way which gave them as much choice and control over their care as possible.
People had opportunities to give their views about the service and these were listened to. They told us the provider contacted them regularly to ask for their feedback and took action to address any issues they raised. People said the provider had made them aware of the complaints procedure but they had never needed to complain as they had regular opportunities to give their opinions about the care they received.
People told us the agency was efficiently managed. They said they had always been able to contact the provider when they needed to and that the provider communicated well with them. Care workers told us the provider encouraged them to give their views about how the service could improve. They said they felt valued as employees and that the provider was always available for advice and support. Care workers told us the provider led by example in the way they provided care to people.
The provider’s quality monitoring system included spot checks on staff providing people’s care. The provider visited people’s homes to check their care workers arrived on time, provided care safely and in line with the their care plan, promoted their independence and treated them with dignity and respect.
The records we checked in the agency’s office relating to people’s care were accurate, up to date and stored appropriately. Care staff maintained daily records for each person, which provided information about the care they received, their food and fluid intake and the medicines they were given. Care records were regularly monitored by the provider to ensure that the quality of recording was appropriate.
Our last inspection of the service took place in June 2014, when no concerns were identified.