Background to this inspection
Updated
21 December 2015
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 provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the agency and to provide a rating for the agency under the Care Act 2014.
We visited the agency on 3 November 2015. This was a small agency and offered care and support to a small number of people. The inspection team consisted of two inspectors.
Prior to our inspection we reviewed information we held about the agency. This included information received and statutory notifications. A notification is information about important events which the provider is required to send us by law. Before the inspection, the provider completed a
Provider Information Return (PIR). This is a form that asks the provider to give some key information about the agency, what the agency does well and improvements they plan to make.
During our inspection we observed how the staff spoke to and engaged with people. We looked at how people were supported throughout the day with their daily routines and activities. We reviewed one care plan and looked at a range of other records, including daily records, staff files and records about how the quality of the service was managed. We spoke with one person who used the agency, four members of staff and the registered manager. Before the inspection we spoke with a visiting professional who had regular contact with the agency.
We last inspected this agency on 25 September 2013. There were no concerns identified at this inspection.
Updated
21 December 2015
The inspection visit took place at the domiciliary care office in Northbourne Village on 3 November 2015. The office is located in Phoenix House, which is a residential care service that is also registered with the Care Quality Commission. Phoenix Domiciliary Care Agency provides care and support to people with mental health needs. The agency is registered to support people in their own homes with personal care and domestic duties. People were able to tell us about the care and support that they received.
People had a tenancy agreement and rented their accommodation. People received support in line with their assessed personal needs. The support hours varied pending on people’s changing needs. People were able to live in their own homes as independently as possible.
The registered manager manages the domiciliary agency and the residential service. At the time of the inspection there were very few people receiving a service from the agency in their own homes. A registered manager is a person who has registered with the Care Quality Commission to manage the agency. 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 agency is run. The registered manager and staff supported us throughout the inspection.
Staff were not always recruited safely. The provider had policies and procedures in place for when new staff were recruited, but these were not consistently followed. All the relevant safety checks had not been completed before staff started work. Some files did not contain appropriate references and gaps in employment had not been explored when staff were interviewed to make sure they were safe to work at the agency. The registered manager took action to address this.
Safeguarding procedures were in place to keep people safe from harm. People felt safe with the staff and the support they received from the agency; and if they had any concerns, they were confident these would be addressed quickly by the registered manager. The staff had been trained to understand their responsibility to recognise and report safeguarding concerns and to use the whistle blowing procedures. Staff had received training in how to keep people safe and demonstrated a good understanding of what constituted abuse and how to report any concerns.
The service was planned around people’s individual preferences and care needs. The care and support they received was personal to them. Staff understood people’s specific needs. Staff had built up relationships with people and were familiar with their life stories, wishes and preferences. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent. Potential risks to people in their everyday lives had been identified and had been assessed in relation to the impact it had on people.
Staff were aware of their responsibilities regarding reporting any accidents and incidents. A system was in place to record accidents and incidents. People’s health was monitored and when it was necessary, health care professionals were involved to make sure people remained as healthy as possible. People were encouraged and supported to have a nutritious and healthy diet.
People had their needs met by sufficient numbers of staff. Staff numbers were based on people’s needs, activities and health appointments. People received care and support from a dedicated team of staff that put people first and were able to spend time with people in a meaningful way.
There were policies and procedures in place to make sure people received their regular medicines safely and when they needed them. At the time of the inspection no-one needed support from staff with their medicines. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable.
The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of the principles of the MCA and how this might affect the care they provided to people. People had capacity and they were asked to provide their consent to the support being provided.
Positive and caring relationships had been developed between staff and people who used the agency. People were involved in the planning and reviewing of their care and making decisions about what care they wanted. People were treated with dignity and respect by staff who understood the importance of this.
People were provided with care that was responsive to their changing needs and staff were aware of people’s individual care needs. People felt able to make a complaint if they wanted to and knew how to do so. There had been no complaints made to the agency.
People and staff were asked for their opinions about the quality of the service the agency provided. There were effective systems in place to monitor the quality of the service and these resulted in improvements when required. The culture of the agency was open and honest and the registered manager encouraged open communication.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.