Background to this inspection
Updated
25 January 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 carried out 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 the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 9 January 2020 and ended on 16 January 2020. We visited the office location on 9 January 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. 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 six people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff and the registered manager. We reviewed a range of records. This included six people’s care records and medicines records. We looked at five files in relation to staff recruitment. A variety of records relating to the management of the service, including quality assurance and monitoring were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We contacted five healthcare professionals and three relatives to ask for their views of the care and support provided.
Updated
25 January 2020
About the service
Four Hills Care Limited is a domiciliary care agency providing personal care for people living in and around Westbury. 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 inspection 43 people were receiving a service.
People’s experience of using this service and what we found
People were supported by staff they knew well. There was a continuity of care provided by staff who people told us were caring. The registered manager told us they would only take on additional packages of care if they had staff to support people safely. Staff were trained and supported by management. Risks were assessed and recorded, and staff had access to all management plans they required.
People told us they felt safe and staff had been trained in safeguarding. Staff understood how to report any concerns and management had worked with the local authority safeguarding team when needed. People had their medicines as prescribed and there was guidance for staff to know what support people needed. We have made one recommendation about ‘as required’ PRN medicines needing more details.
People knew how to complain and told us they would if they needed to. People had care plans which gave guidance on how they wanted to be cared for. These were reviewed regularly. Care plans were electronic, so staff could access them at any time. People and relatives could also access their records when they wished.
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’s consent to their care package was recorded in their care plans.
Staff had been recruited safely. Staff told us they enjoyed their work and felt supported in their roles by the management team. There was good teamwork and staff told us they all supported each other when needed. Team meetings were held regularly so staff could share information.
Quality monitoring systems were in place and were effective at identifying improvements. The service worked in partnership with many healthcare professionals. There was guidance for staff to know about people’s health needs in their care plans. We have made a recommendation about information provided to staff on knowing how to support people’s diabetes.
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 24 April 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.