Background to this inspection
Updated
5 February 2019
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.
Inspection activity started on 17 December and ended on 20 December 2018. The inspection was announced. The provider was given 48 hours’ notice because the registered manager and staff were often out of the office supporting people and we needed to be sure they would be available.
The inspection was carried out by one inspector. Following the inspection site visit on 19 November 2018, an Expert by Experience contacted people who used the service and relatives to gain their views on the service provided. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service.
As part of planning our inspection, we contacted the local Healthwatch and the local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England. We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.
The provider sent us their Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.
During the inspection we spoke with 11 people who used the service and four relatives to gain their views on the service provided. We also spoke with six members of staff including the registered manager.
We reviewed a range of documentation. This included three people's care planning documentation and daily records and five people’s medicine administration records. We looked at two staff files relating to their recruitment, supervision, appraisal and training. We reviewed records relating to the management of the service and a wide variety of policies and procedures.
Updated
5 February 2019
This inspection took place between 17 and 20 December 2018.
Town and Country Care (Whitby) Ltd is a domiciliary care agency. It provides personal care to people living in their own homes to predominantly older people. At the last inspection the service was rated ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At the time of inspecting 80 people were receiving a regulated activity. Not everyone using the service receives a regulated activity; CQC only inspects the service being provided by people with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
A registered manager was in post. 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.
Safe understood and followed safeguarding procedures to protect people from harm. Where risks to people were identified, appropriate plans to manage these were in place.
Medicine had been administered safely. Staff had received medicines training and regularly had their competencies in this area assessed. People told us staff followed good infection control practices and the provider ensured personal protective equipment was readily available.
New staff received a thorough induction to the service and were supported with regular one to one supervisions and observations. A thorough training program was in place.
People were supported, where needed, to maintain good food and fluid intake. Care records clearly detailed the level of supported people required.
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. Consent to care and treatment was recorded and staff respected people’s choices.
People told us they were actively involved in the planning of their care. Care records contained person-centred information. Regular care reviews had taken place to ensure the support in place continued to meet their needs. People were encouraged to engage with others to avoid social isolation.
People told us staff were kind and caring and treated them with dignity and respected. Staff were knowledgeable about peoples likes, dislikes and preferences and positive relationships had been developed. Care records showed that people were encouraged to remain as independent as possible. Staff provided advise on where aids to maintain independence could be sourced.
The management team were friendly, approachable and responsive. People were asked to provide regular feedback on the service provided. Quality audits had been conducted to monitor and improve the service although these were not always consistently recorded.
The registered manager was continuously trying to develop the service through the introduction of electronic systems and initiatives to retain staff. Staff told us they were well supported and valued by management.
Further information is in the detailed findings below.