Background to this inspection
Updated
4 October 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 took place on 10 August 2017. We gave the provider 48 hours’ notice to make sure that there would be someone at the office at the time of our visit. The inspection was carried out by one inspector. The inspection team also included an expert by experience who spoke to people who used the service on the telephone. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
Before the inspection we looked at the information we already had about this provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. These help us to plan our inspection. The provider was asked to complete 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. This information was received when we requested it. We considered feedback provided to us by commissioners of the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan what areas we were going to focus on during our inspection.
During our inspection we spoke with the registered manager, operations manager, office staff and five care staff. We sampled the records relating to four of the people using the service and records relating to staff recruitment and training. We also reviewed records relating to the management and quality assurance of the service. We contacted and spoke with six people and four relatives who used the service. We also sent surveys to 22 people using the service and received six responses.
Updated
4 October 2017
This inspection took place on 10 August 2017. We gave the provider 48 hours’ notice to make sure that there would be someone in the office at the time of our visit. First Practice is a domiciliary care agency which provides personal care to people in their own homes. At the time of our visit there were 70 people using the service.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.
We had inspected the provider’s previous location in August 2016 but this had now closed and this was the first inspection of this new location.
Some systems were in place to regularly assess and monitor the quality of the service. This included checks on staff competency, a range of audits such as medication and regularly seeking the views and feedback of people and staff. Improvement was needed to ensure people received a consistently good service.
People confirmed they felt safe with the staff. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice. Individual assessments identified environmental and individual risks. They were up to date and detailed guidance for staff to follow to reduce these risks effectively.
People who required assistance to take their medicines told us they were happy with how they were supported. Staff had received training and were assessed as competent to support people to take their medicines.
Checks were completed on potential new staff before they started work to make sure they were suitable to support people and the provider made sure there was enough staff at all times to meet people's needs. Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.
There was sufficient staffing capacity and most people now had their own team of allocated care staff for consistency. People described the staff as being kind and caring and staff spoke affectionately about the people they supported.
People who required assistance to eat and drink told us that they were supported by staff who understood and met their nutritional needs and preferences. People were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.
People's right to make their own decisions about their own care was supported by staff. Staff worked in accordance with the principles of the Mental Capacity Act 2005 (MCA) and sought people's consent before offering care.
The provider had arrangements in place to deal with any concerns or complaints. People told us that they would not hesitate to contact the agency office if they had a concern. People, relatives and staff said the registered manager was approachable and available to speak with if they had any concerns.