14 August 2014
During an inspection in response to concerns
We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
We saw people's care had been arranged according to their personal needs. People we spoke with told us they had reviews to make sure care plans were accurate and up to date.
We found there was a process in place for managing risks associated with people's care. Some people who used the service were unable to move around without assistance. There was detailed information in care plans for staff about how to move people safely. People told us care workers were competent in using equipment, including a hoist.
All the people we spoke with said they felt safe with their care workers and were confident any concerns or complaints would be investigated by the service.
We asked people if they thought staff were properly trained to provide the support they needed. We were told; 'Yes, they know what to do' and 'Yes and if it's a new person they always have someone with them'.
Is the service effective?
People told us they had been involved in planning their care and the care they received met their needs. We saw care plans were reviewed and updated regularly so care staff could continue to provide the correct level of support.
Staff we spoke with said they were allocated regular clients and were allocated sufficient time to carry out all the tasks required. People said care workers arrived around the time expected and stayed long enough to do everything they needed. People said staff 'logged in' by telephone when they arrived and left. One person told us, 'They do this to let the office know they have arrived and the office can tell if they are running late.' Some people told us they had experienced late calls. They said this was due to care staff leaving and being replaced with another carer.
We found staff had regular supervision and their practice was observed to make sure they provided care and support in line with the provider's policies and procedures.
Is the service caring?
Care plans contained information about people's likes and preferences. This made sure people received care in a way they preferred.
We asked people if care workers treated them in the way they liked. Everyone indicated that people were treated as individuals. Comments from people included, 'They treat me as I would expect them to.' We asked people if care workers were polite and respected their privacy. One person said care workers were, 'Always respectful and very polite.' People indicated the carers were kind and understanding. Comments included, 'Yes, very kind and friendly. They try to make time for a chat and cup of tea.'
Is the service responsive?
People told us they were asked for their views and opinions during reviews and any changes were recorded and acted on. People told us that concerns were listened to and acted on.
People told us care staff noticed when their needs changed and took action. For example when asked if staff monitored people's skin to make sure it remained intact and healthy, a relative told us, 'They check when they provide personal care. They apply the cream and let me know if there is any redness'
Staff we spoke with said there was an 'on call' system. We were told, 'If you leave a message the on call person always gets back to you.'
Is the service well led?
The service had a clear management structure in place and senior staff spoken with understood their role and associated responsibilities.
We found the service had a quality assurance system in place. This included regular reviews with people who used the service, telephone conversations and staff spot checks. The service had auditing procedures in place to make sure staff provided care to people as recorded in their care plans and worked in line with the provider's procedures. Staff received regular supervisions that included work based observations to make sure they worked in line with policies and procedures.
People who used the service told us they were satisfied with the service they received. Comments from people included, 'I am happy with my carers.' 'Yes I am quite satisfied with the service I get.' 'When it is working properly it is great.'