Background to this inspection
Updated
3 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was conducted by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because we needed to give people the opportunity to meet with the inspector in their own homes.
Inspection activity started on 20 June 2019 and ended on 24 June 2019. We visited the office location on 20 June 2019.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and two relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, two coordinators and seven care workers.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
3 July 2019
About the service
Peace of Mind Homecare is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection 82 people were receiving care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Staff completed training in adult safeguarding and were aware of their responsibilities to report any concerns. Systems and processes were in place to reduce the risk of harm. Safe recruitment practices were used to ensure that new staff were suited to working with vulnerable people. Medicines were well managed with only two reported medicines’ errors in the previous 12 months. Staff understood the need for effective hygiene standards to reduce the risk of infection. Staff recorded incidents and accidents in sufficient detail to aid analysis and reduce risk.
People were supported to maintain a healthy diet in accordance with their needs and preferences. The service worked well with other agencies to provide care which had a positive impact on people’s health and wellbeing. Staff clearly understood the benefits of supporting people to improve their health and wellbeing through exercise and diet. When people were unwell staff acted promptly to ensure that they received appropriate care and treatment. People were involved in discussions about their care and their outcomes were good. Staff were given an induction in accordance with recognised standards for care staff. Staff told us that they felt well supported. The service was working in accordance with the principles of the MCA. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and their relatives spoke very positively about the caring nature of staff. They told us that they were always treated well by staff and were involved in decisions about their care. We saw a number of examples where staff spoke to people and about people with kindness and respect throughout the inspection. Staff were clear about their responsibilities in relation to equality and diversity and supported people appropriately. People spoke positively about the way in which staff respected their rights to privacy and dignity in all aspects of their care.
We saw clear evidence that people’s individual needs and preferences were consistently considered as part of the care planning process. Staff knew people’s personal histories and their likes and dislikes. They used this information to hold conversations and to suggest activities. However, it was clear that staff knew more about people and their routines than was recorded in care records. We discussed this with the registered manager who made a commitment to add more information to the records as a priority. Staff understood the need for effective communication and the service met the requirements of the Accessible Information Standard. Staff clearly understood the importance of supporting people to develop and maintain relationships and reducing the risk of social isolation. The service had not received any formal complaints in the previous 12 months. We were told how the service had responded positively when minor concerns were shared. The service did not routinely support people receiving end of life care. However, people’s end of life wishes were recorded in care files.
Throughout the inspection the comments and behaviours of the registered manager and other senior staff consistently reflected their commitment to a genuinely person-centred service. It was clear that this had resulted in positive outcomes for people. Each of the staff that we spoke with understood their role and responsibilities. However, it was not clear from records how oversight was provided at the most senior (provider) level. The service placed continuous learning and improvement at the heart of their practice. They made effective use of audits, reports and other forms of communication to monitor and improve the safety and quality of care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 11 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.