Background to this inspection
Updated
22 April 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 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 service, and to provide a rating for the service under the Care Act 2014.
This inspection was carried out on 28, 29 and 30 March 2017 and was announced. We gave the service 48 hours’ notice of the inspection because they provide a domiciliary care service and we needed to be sure that the registered manager and members of staff would be available. The inspection team comprised of one 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. In this case, they supported us by making phone calls to people and their relatives.
Prior to this inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We spoke with the local authority and clinical commissioning group (CCG) to gain their feedback as to the care that people received.
On the second and third day of the inspection we carried out phone calls to people and their relatives, to seek their views about the care they received. In total we spoke with six people and five relatives. We also spoke with staff members over the phone on days two and three and in person during our site visit on day one. We spoke with five care support workers, a senior care practitioner and two locality managers. We also spoke with an administrator, the registered manager and the chief executive officer from the provider.
We reviewed the care records of six people who received care from the service to see if they were up to date and contained information which was reflective of their current care needs. We also reviewed records relating to the running of the service, including recruitment records for five staff members, training records and quality assurance procedures.
Updated
22 April 2017
Carers Trust North Bucks and Milton Keynes provides people with personal care and support in their own homes. They have a rural office in Buckinghamshire and provide people with care packages around north Buckinghamshire and Milton Keynes. When we inspected they were providing 39 people with personal care support packages.
At our previous inspection on 30 March 2016 we found that the service was in breach of one legal regulation. The service had not taken steps to assess risks to the health and safety of people, or taken sufficient action to ensure that risks would be mitigated against. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We asked the provider to send us an action plan to tell us what action they would take to meet this breach. We reviewed their action plan and carried out this visit to ensure they had carried out the improvements within that plan, as well as improvements in other areas of the service. Following the inspection we found that the service was no longer in breach of our regulations.
We found that there had been improvements to the way that risks were managed at the service. Risk assessments were in place and were more comprehensive in identifying areas of risk. Future work was also planned to improve the way these documents provided staff with information about actions they should take to help mitigate risks.
People felt safe in the care they received from the service and staff had a good knowledge of abuse and potential indicators that abuse had taken place. There were systems in place to record and report any incidents, including concerns around abuse, which took place and appropriate contact was made with external organisations. Staffing levels were sufficient to meet people's specific needs and people were usually able to see regular and familiar staff. Staff had been recruited following robust procedures to ensure they were appropriate and of good character to be working with people.
If necessary, staff were able to support people to take their medication but where possible, people did so independently. There were systems in place to ensure medicines were recorded when staff did support people with them and these were reviewed to ensure this was done so properly.
Staff members received training and support from the provider to ensure they were able to perform their roles. New staff received induction training and there were regular updates and ongoing training for established staff. Supervisions took place to provide staff with opportunities to discuss their roles, any concerns they had and future training needs.
People's consent to their care, treatment and support was sought by staff on a daily basis. People signed their care plans to show they agreed to them and were empowered to make decisions for themselves. None of the people the service cared for were assessed as lacking capacity to any decisions, however, the service did have systems in place to ensure they were meeting the principles of the Mental Capacity Act 2005 should the need arise. People were able to choose what they wanted to have to eat or drink and staff only provided the assistance that people required, so as to maintain people's independent living skills. If necessary, staff were also able to support people to access appointments with healthcare professionals, such as their GP, and took action to ensure their recommendations were followed in people's care plans.
Staff treated people with kindness and compassion. They took the time to get to know the people they were caring for and were motivated to perform their roles and make sure people got the care they needed. People had been involved in the writing of their care plans and were provided with information and updates about the service. Staff members took action to ensure that people were treated with dignity and respect at all times and that their privacy was maintained.
Care plans were based on information that was received from people and their family members, to ensure they were person-centred. Initial assessments were made so that the service could make sure they could meet people's needs and care plans were based upon this information. They were reviewed with people and their family members on a regular basis, so that they were kept up-to-date. People were able to provide the service with feedback and make complaints and these were used to help drive improvements in the way that care was delivered.
There was a positive and open culture at the service. People were happy with the care that they received and staff were motivated to meet their needs. People and staff members felt well supported by the registered manager and office staff and there were quality assurance systems in place to allow the registered manager and provider to review the care being provided and make improvements where necessary.