Background to this inspection
Updated
29 February 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
The inspection was carried out by an inspector, an assistant inspector, a directorate support coordinator 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
This inspection was unannounced.
What we did before the inspection
We reviewed the information we held about the service. This included copies of the action plans they had submitted to us after our last inspection as well as notifications they had submitted. Notifications are information about events providers are required by law to inform us about. We sought feedback from the local authority and safeguarding team where the service is based. 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 the office based staff which included the registered manager, the operations manager, the deputy manager, a coordinator and a coordinator assessor. We reviewed the care files for ten people including assessments, care plans, records of care and reviews. We reviewed ten staff files including recruitment and supervision records. We reviewed various meeting minutes, newsletters, audits, training records and other information relevant to the management of the service.
After the inspection
We spoke with seven people and four relatives by phone. We spoke with nine care workers. We received and reviewed various policies and documents relevant to the management of the service.
Updated
29 February 2020
About the service
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of the inspection they were providing personal care to 101 people.
The service is registered for both personal care and treatment of disease, disorder and injury (TDDI). TDDI is clinical care and treatment that is often delivered by nurses when based in a domiciliary care agency. However, at the time of the inspection they were not delivering TDDI.
People’s experience of using this service
People told us they felt safe and well supported by staff who knew their needs and how to meet them. Our previous concerns about the quality of risk assessments had been addressed and risks to people had been appropriately identified with clear plans to address them. Our previous concerns about the governance of the service had been addressed and there were robust systems in place to ensure the quality and safety of the service.
People told us they were supported by regular staff who informed them if they were running late, or would be unavailable. There were multiple electronic call monitoring systems in place which meant it was not easy to tell if people were receiving their care at the times they wanted. We have made a recommendation about this.
People were supported to take their medicines by staff who had been recruited in a safe way and received appropriate training to do their jobs.
People’s needs were assessed and the provider had changed their care plan format to make it more flexible and suitable for people’s changing needs. Staff had good information about people’s healthcare needs and the support they needed to stay healthy. Where it was part of their support people were happy with how staff supported them with their meals.
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 knew how to make complaints, and felt confident any concerns they had would be taken seriously. People and their relatives were invited to give feedback regularly and through various formats.
There were systems in place to ensure the continuous improvement and development of the service.
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 requires improvement (published February 2019).
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.