An inspector visited this service on 22 July 2014 to carry out an inspection. Prior to our visit we looked at all the information we hold on this service to help us to plan and focus on our five questions: is the service safe; is the service effective; is the service caring; is the service responsive; and is the service well led?The summary is based on a visit to the service office where we looked at records and talked to the manager and office manager. Following the visit an expert by experience contacted, by telephone, a sample of people who used the service and relatives of people using the service. We also talked to some care staff.
Is the service safe?
We found that the service carefully assessed and managed risks to people's personal safety to make sure their care was delivered in a safe way.
There were appropriate arrangements in place to manage people's medicines safely and we saw that staff had been appropriately trained in medication administration. With the exception of one person people indicated that they were happy with the way their medication was given. The one incident raised by a relative was followed up with the office manager and the manager of the service.
People we spoke with told us that they felt safe with the care staff. Some comments were: 'I'm not being neglected. They come and make sure that I eat', 'They're very good. I don't have any problems with them' and 'They are very pleasant to have in the house.'
Is the service effective?
The manager told us that a service was provided on the basis of an assessment of the individual's needs and a written plan of care. People using the service, and when appropriate their representatives, had been involved in the drawing up the care plan.
People's care was well planned and was kept under regular review to check it remained effective. Care plans were updated in a timely manner if changes or updates were needed. Some comments we received from people using the service and their relatives were: 'Care plans are kept at home and the carers write in it every day,' 'His care plan is kept at home and they (carers) keep a record of all their visits' and 'They make a note in it (the care file) every visit'.
Some comments from relatives of people using the service included: 'It (the care) enables him to live at home. If he didn't have the service he wouldn't be able to live here', (The carer) 'Is usually someone he knows. They let themselves in to the house' and 'We are very happy with the support we have been given. It's been excellent',
The care staff we spoke with told us that they felt supported by the manager. Some comments included: 'I've been impressed with Quality Care as an employer. They have supported me all the time', 'I feel valued and it feels like a worthwhile thing I'm doing', I wouldn't swap it (the job)', 'When I started I went out with two other carers and shadowed them for about two weeks it's brilliant' and 'You can go to her (the manager) for anything.'
Is the service caring?
The majority of people we spoke with told us they were happy with the care and support they received. Some comments included: 'The care they give you is good', 'One girl is very good. She is excellent. They are all lovely people' and 'I'm quite happy with the care I get.' However one person said 'The care is OK but they are sometimes a bit rushed.' Another comment was 'It depends who comes, some will do more than others.'
The care plans seen contained details of the care needed at each visit and how the care should be given in accordance with people's wishes and personal preference while also maintaining independence. One member of staff said 'As long as you follow the Care Plan it all fits in (in the time allocated).'
Is the service responsive?
The manager told us that quality questionnaires were due to be distributed to people receiving a service or their relatives and staff in order to obtain their views and opinions about the service. We were told that the results would be analysed and a report produced. We saw the report from analysed results of the quality questionnaires for 2013/2013 which was positive. Some people using the service, relatives and staff confirmed that they were able to give comments about the service being delivered.
We saw there was a complaints procedure in place which was also included in the service user guide which we were told each person using the service had received a copy of and it was also included in the staff handbook. People spoke with confirmed that they had not made a complaint but knew what to do if they felt a complaint was necessary. Some comments included: '(If I had a complaint) I'd ring and speak to the lady. She has made that clear', 'If I thought something wasn't satisfactory I'd tell them' and 'When a visit was missed I rang them up and they did something about it.'
We looked at the records of complaints made which showed that everything had been documented and investigations and responses to the complaints were carried out within the specified timelines. This meant that people could be confident that their complaints were listened to and dealt with effectively.
Is the service well led?
The manager and staff had a good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were in place to check standards were maintained. People were routinely consulted about their level of satisfaction and feedback was used to improve the quality of the service.
All staff spoken with told us they had regular supervision and annual appraisals. Staff also told us 'The training is immense and classed as compulsory,' 'We're up to date on all our training', 'We've been trained to treat ourt service users as our parents' and 'The manager and senior carers will keep checks on what you have done. We all know we are spot checked. It helps keep standards high'.
The agency ran a weekly club called 'socially yours' in a local church hall. The club was open to all of the people who use d the service and people from the local community. At the time of this inspection visit the club had taken a number of people on holiday to Blackpool to a fully adapted hotel which catered for people with disabilities and provided their own domiciliary care. Five care staff and the manager accompanied the people on their holiday.