Background to this inspection
Updated
21 March 2020
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 undertaken by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 to enable consent to be gained to visit people in their own homes.
Inspection activity started on 25 February 2020 and ended on 27 February 2020. We visited the office location on 25 February 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 14 people who used the service and four relatives over the phone, about their experience of the care provided. We also visited four people in their homes to gain their feedback. We spoke with nine members of the staff team, including the registered manager.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three 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.
Updated
21 March 2020
About the service
Hoylake Cottage is a domiciliary support service providing personal care to people in their own homes. 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. At the time of the inspection, 61 people were receiving support with personal care.
People’s experience of using this service and what we found
Records regarding medicine administration were not always maintained accurately and we made a recommendation regarding this. Staff were knowledgeable about safeguarding and concerns had been referred to the local authority appropriately. Staff knew how to respond in the event of an emergency and people told us they felt safe with the support they received. There were sufficient numbers of staff employed to meet people’s needs and most people told us they received support from a consistent group of carers that they knew, although this was not always possible.
People’s feedback regarding the quality of service they received was very positive. More formal systems could be implemented to ensure records regarding people’s needs were always stored securely to protect people’s confidentiality. People knew their core team of carers, but did not always know which carers would be supporting them each day, which some people felt could be improved. A range of regular checks were completed to monitor the quality and safety of the service, but these could be further developed to ensure they help drive forward improvements. Regular observations and spot checks were completed to ensure staff continued to provide high quality support to people. Systems were in place to engage with people and gather their feedback regarding the service, such as reviews, quality assurance surveys and a complaints process.
People received care that met their individualised needs and preferences. It was clear that support was adapted to meet people’s changing needs. Care plans were detailed, although some required updating to reflect the care that was being provided and we made a recommendation about this. Staff worked flexibly to meet people’s changing needs, including their religious needs. A complaints policy was available, and people knew how to make a complaint. Staff worked closely with district nurses to ensure people’s needs were met well at the end of their lives.
People told us, “Staff respect me and my home” and they were “Very caring staff, they cannot do enough for me.” Relatives agreed and told us, “I have no concerns that the staff look after [relative] at the highest standard.” Staff spoke warmly about the people they supported, and language used in records about people was respectful and reflected the care people wanted. Satisfaction surveys were sent to people to gain people’s views regarding the care provided to them and people told us they were involved in decisions about their care. People’s privacy and dignity were maintained by staff and they never felt rushed.
Staff completed a comprehensive induction and were supported in their roles through regular training, supervisions and an annual appraisal. When people required support with meals and drinks, this was clearly recorded within their plans of care. Staff worked with other health and social care professionals to ensure people’s needs were met.
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. When able, people consented to their care and if there were concerns regarding people’s capacity to make specific decisions, the registered manager liaised with the person’s social worker or GP.
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 9 August 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.