This inspection took place on the 14 and 29 September 2016 and was unannounced. The agency was previously inspected in October 2013, and at the time was meeting all regulations assessed during the inspection. The service had a registered manager who managed the day to day operations of the service. 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.
Home Support Service is an agency providing personal care to people in their own homes. The service provided is a re-enablement service and provided care and support to people when they came out of hospital for a period up to six weeks. During this time people were assessed to determine if they could manage on their own or required a permanent care package, which would then be provide by a different provider. The service was provided throughout Sheffield. The service supported between 300 and 500 people, this changed weekly as on average 80 new packages were taken each week and others discharged. At the time of our inspection 389 people were receiving a package of care. Length of visits depended on people and the frequency of visits ranged from one visit per week to four visits per day depending on people individual needs. Visits would be reduced as people improved and their needs decreased.
We received positive feedback from people we spoke with. They told us that, “They are willing, kind and very courteous; really happy with them.” Another person said, “Nothing is too much trouble, I can’t complain about anything.”
People told us they felt safe when staff visited and staff did their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to people. For example, we saw staff had made referrals to the falls team and referrals for equipment to keep people safe. This demonstrated that they had acted on the information gained at the assessment which ensured people were safe.
The service actively involved people in their assessment. This was carried out on the day they were discharged form hospital. Assessment officers met the people at their home with family members to go through the support required. This meant peoples choices, likes, dislikes and decisions were incorporated into the plan of care and support.
The registered manager told us that all staff were trained to undertake risk assessments which meant they could identify any issues both in the home environment or risks to people’s safety while in the community. The service also had clear lone worker policies which protected staff when working alone in the community.
People were supported to take their medication safely and the care records identified the level of support needed for each person. The service ensured that priority for visits were given to support medication calls to ensure that people’s medication needs was given at the time prescribed. For example, pain relief medication which may be needed to ensure people were pain free to mobilise and be able to support themselves. However, we identified that medication procedures and systems required some improvements.
People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. The provider listened to all complaints and made sure people were confident their complaints would be taken seriously. There were also surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received.
The service promoted an open and honest culture and the managers and care co-ordinators were transparent in their discussions with us. Staff spoke highly of their teams and felt well supported by their care co-ordinators. The service was at the time of our inspection in the process of a reorganisation and some staff had left or were in the process of leaving. Staff told us this had been a difficult time but the provider had kept them informed and communication during the transition had been very open. Staff were confident they could raise any concerns or issues, knowing they would be listened to and acted on. Staff said, “I love my job I get a lot of satisfaction form it.” Another said, “We are well supported and we all work well as a team.”
People told us that staff were very professional and always respected their dignity when undertaking personal care tasks. Staff we spoke with were highly motivated to provide a good service to people they supported. One staff member said, “If we find a problem we ensure the person is ok and inform the office, we would not leave a person until we knew they were alright.”
Staff working at the service were recruited safely and were able to complete training to meet the support people needed. The service also enabled staff to undertake nationally recognised training to help them progress in their work.
The registered manager was committed to continuous improvement and feedback from people, whether positive or negative, was used as an opportunity for improvement. The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.