Our Inspector gathered evidence to help answer five key 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 based on the evidence gathered during our inspection carried out on 02 April 2014. This included speaking with people who used the service, some of their relatives and members of staff who supported them and by looking at records.
The detailed evidence that supports our findings can be read in the full report.
Is the service safe?
During our inspection of the service people told us they had been treated with respect and dignity. One person said, 'They [staff] help me in a way that is very respectful and kind; I never feel awkward. At first I was very worried, anxious and embarrassed. I need not have worried'.they put me at ease and reassured me straight away and now I feel comfortable.'
We looked at records which showed that people's care and support needs had been assessed, documented and reviewed. They were personalised and gave staff clear guidance on how to deliver safe and appropriate care that met people's individual needs. One person told us, 'They [staff] look after us wonderfully well and record what happens in our support plan which we can read.'
Published guidance about safeguarding vulnerable people had been made available to staff and put into practice. People who used the service had been protected from the risk of abuse and told us they felt safe. One person commented, 'I feel very safe and secure with them [the service].'
We saw that the provider had put suitable arrangements in place to identify, monitor and manage potential risks to the health, welfare and safety of people who used the service.
For example, we saw that visits made by care staff to people in their homes had been monitored electronically. Information about potential delays or other problems impacting on the ability of staff to attend scheduled calls was immediately brought to the attention of a member of the management team. This was achieved by real time monitoring and by both email and mobile phone text alerts linked to the computer system. This meant that the risks associated with late or missed calls had been significantly reduced.
Is the service effective?
People told us they had been involved in the assessment of their individual needs and in the planning, delivery and reviews of the care and support they received. One person said, 'I have been kept fully involved in what goes on from the beginning. My care plan is reviewed regularly and they [staff] make any amendments that I ask for. I feel in control of what goes on which is great.'
People had access to their care and support plans. We saw that these had been reviewed and updated with them on a regular basis.
The provider had put suitable arrangements in place to ensure that staff were appropriately trained and supported to perform their roles. One member of staff told us, 'The induction and training were really good. All staff must complete training, practical assessments, observations and competency checks before being allowed to deliver personal care alone. The manager supports and encourages us to develop new skills.'
Is the service caring?
We spoke with three people who used the service and two relatives who were very positive and complimentary about the levels of care provided and the care staff who supported them. The relative of one person who used the service told us, 'The carer is lovely, always arrives on time, is polite and always does what needs to be done. My [family member] has the same carer all the time who is never late and always stays the agreed amount of time.'
We spoke with three members of staff who all demonstrated a kind, respectful and caring attitude toward the people they supported. One member of staff commented, 'The care plans are very good but I also ask people what they want. I get to know them and their needs. I take time to find out about them. I talk with them, reassure them and make them feel at ease and respected.'
However, we looked at care records relating to three people who used the service and found that some of them were incomplete in some respects.
For example, in two of the assessment of needs records we looked at, the sections used to record information about people's background information, personal history and preferences had not been completed. This meant that some aspects of people's care records were not as accurate, complete or effective as they could have been.
Is the service responsive?
People told us they had been provided with sufficient information which enabled them to understand and make informed choices about the levels of care and support they received. One person said, 'I have been given a really good information pack that contains lots of useful information and advice. The staff have got to know me well which means they can look after me in a way that suits me.'
We saw that people had been given information about how to make a complaint if the need arose and had provided their signatures to acknowledge receipt of a copy of the relevant policy and procedure. Everybody we spoke with told us they knew how to make a complaint but had not had the need to do so.
Is the service well led?
Records showed that the provider had put suitable arrangements in place to manage risks effectively and to regularly assess and monitor the quality of services provided.
For example, we saw that systems had recently been introduced which enabled the provider to review management information gathered from a variety of sources about the quality of service and potential risks. This included information about complaints, care plan and medication audits, punctuality, staff performance and the outcome of quality assurance calls and visits to people who used the service.
A relative we spoke with commented, 'The management have been very efficient and effective. We have had regular contact from them asking about our views on the quality of service and they have dealt with any concerns or issues we have raised very quickly. They encourage us to provide feedback and let us know straight away when changes or improvements have been made.'