This inspection took place on 20 May 2016 and was announced. We made phone calls to people, relatives and staff who use the service on 23, 24 and 26 May 2016. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because People in Action provide personal care for people who live in their own homes and we needed to be sure that someone would be available at the office. At the time of our inspection eight people used the service.
The registered manager had left the organisation two months prior to our inspection. We were not notified that the registered manager had left or what plans the provider had in place to register a new manager with the CQC. We only discovered this information when we gave notice to the provider of our inspection. On the day of our inspection there was a branch manager and a deputy manager. The branch manager had worked for this service for 12 months and explained that their area manager would be applying to become registered manager. Throughout the inspection we spoke with the branch manager as the area manager was unavailable at the time of our inspection.
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.
People felt safe with the staff who provided their care and felt they were protected from the risk harm. Staff recognised signs of abuse and knew how to report this. The branch manager ensured people’s risks had been looked at and took actions to minimise risks without taking away people’s right to make their own choices.
People told us there were enough staff to support them at the times they needed them. Staff told us they felt there were enough staff to provide safe care and support to people. The branch manager told us that advanced planning of staffing levels meant they knew that people’s needs were able to be met. People’s medicines were checked and managed in a safe way.
We found that the care and support people received was in-line with the Mental Capacity Act (MCA). However the provider had not tested that the actions they had needed to take, which were in line with the person’s best interests might amount to depriving the person of their liberty. The provider had not discussed this with the local authority, so that the Local Authority could submit an application to the Court of Protection to ensure the person was not being unnecessarily deprived of their liberty.
People were supported to eat a healthy balanced diet and were supported with enough fluids to keep them healthy. Staff supported people with access to healthcare professionals, and provided flexible times to ensure they made their doctor or hospital appointments.
People and where appropriate, family members, were involved in the planning around their care. People’s views and decisions they had made about their care were listened to and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.
People knew how to make a complaint and felt comfortable to do this should they feel they needed to. People were provided with the information they needed should they wish to raise a complaint. The provider had not received any complaints over the last 12 months.
We found that the checks the provider completed focused upon the experiences people received. Where areas for improvement were identified, systems were in place to ensure that lessons were learnt and used to improve staff practice. Staff felt supported by the branch manager to carry out their roles and responsibilities effectively.