Background to this inspection
Updated
21 February 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered persons were meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
The inspection was conducted by a single inspector between 10 and 12 January 2017 and was announced. The registered provider was given 48 hours’ notice of our inspection visit. We did this because the registered manager was regularly out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available in order to contribute to the inspection process.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form the provider completes to give some key information about the service, what the service does well and improvements they planned to make. The provider returned the PIR to us and we took this into account when we made our judgements in this report.
In addition, before the inspection we sent questionnaires to 20 people who use the service, 20 relatives and friends, 51 staff and 12 community health and social care professionals. We used feedback sent to us by those who returned them to inform the planning for our inspection. We also reviewed other information that we held about the service such as notifications (events which happened in the service that the provider is required to tell us about) and information that had been sent to us by other agencies such as commissioners of the service and Healthwatch England.
During our inspection we spoke with the relatives of five people who received direct support in their own homes by telephone to seek feedback about how their needs were being met. As part of our inspection we also made two visits to the provider’s office. During these visits we spoke with four care staff direct and four care staff by telephone. We also met with two care co-ordinators, two field care supervisors, two clinical lead nurses who were employed by the provider, the service administrator and the registered manager.
In addition, we looked at a range of documents and written records about how services were being provided including seven people’s care files, six staff recruitment files, information relating to the administration of medicines and the monitoring and management of the overall service provision.
Updated
21 February 2017
The service provides personal care and support to people living in their own homes in Lincolnshire.
This inspection took place between 10 and 12 January 2017. The inspection was announced. At the time of our inspection 48 people were receiving support from the service. 36 people were being cared for under the regulated activities of personal care and treatment of disease disorder or injury (TDDI). The people receiving care included children, adults and older people who experienced a range of healthcare needs.
The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with CQC 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.
People’s needs were assessed and planned for in a structured way. Any potential risks to people and staff, including environmental risks were identified before any new services were started. This helped ensure risks were minimised.
Staff understood how to report concerns about potential abuse and when it had been needed, the registered manager and staff took action to keep people safe from harm. Care plans were in place which helped inform staff about individual care needs and any potential risks to people’s health and wellbeing.
Staff were recruited safely and there was an on-going recruitment programme in place which was used by the provider to maintain staffing at the levels they had identified as needed.
Staff undertook training in a range of of subjects relevant to the care needs of the people they supported. The training was used to maintain and develop their existing skills. Staff worked together in a co-ordinated way and were provided with regular support and supervision including direct observation of their care practice by the registered manager and senior staff.
CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this area and if people lacked capacity to make their own decisions the principles of the MCA and codes of practice were followed in order to protect people’s rights.
People who needed staff assistance to take their medicines were supported to do this and staff assisted people to eat and drink enough to keep them healthy whenever this type of support was required.
Staff were caring and they worked in ways which helped people and their families to maintain their community interests and social lives.
The provider and registered manager listened to what people had to say and took action to resolve issues or concerns when they were raised with them. There were systems in place for handling and resolving concerns and more formal complaints.
The provider had a range of quality monitoring systems in place which included audits, reviews and surveys. These were used by the registered manager to organise and manage the service in a structured way.
The provider and manager regularly reviewed and reflected on the systems they had in place to manage the service. When action was needed they responded in ways which enabled them to keep developing and improving practices for the future.