The inspection took place on 21 and 22 March 2016 and was announced. This meant we gave the provider 48 hours’ notice of our intended visit to ensure someone would be available in the office to meet us.We last inspected Perfect Care on 11 February 2014, at which time it was meeting all our regulatory standards.
Perfect Care is a domiciliary care provider based in Spennymoor providing personal care to people in their own homes in the County Durham and Darlington area. The service is also registered to provide nursing care in people’s own homes although no one was receiving nursing care at the time of our inspection. At the time of our inspection the service provided personal care to 112 people.
The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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. The registered manager had extensive experience of working in the social care sector.
We found the service had in place a range of risk assessments to ensure people were protected against a range of risks and that these risk assessments were regularly reviewed.
There were effective pre-employment checks of staff in place and effective supervision and appraisal processes, with all staff we spoke with confirming they were well supported.
Medicines administration was found to be safe and in line with recognised good practice, with people not at risk of unsafe medicines administration.
We found infection control procedures were in place and people were protected against the risk of acquired infections.
People who used the service, relatives and external healthcare professionals expressed confidence in the ability of staff to ensure people were safe. No concerns were raised from relatives, external healthcare professionals or local authority commissioning professionals on this issue.
We found there were adequate staff to ensure people’s needs were met safely. We found policies regarding the planning of care calls were clear but, on occasion, the staffing rota had not been managed to ensure the adequate provision of travel time.
We found staff were trained in core areas such as safeguarding, food hygiene, first aid, as well as training specific to the individual needs of people using the service, for example dementia and PEG feed training.
We found staff had a good knowledge of people’s likes, dislikes, preferences and communicative needs.
We found care plans to be person-centred and sufficiently detailed so as to give members of staff a range of relevant information when providing care to people who used the service. We saw these care plans were reviewed regularly and with the involvement of people who used the service, relatives, healthcare professionals and, where applicable, advocates. We saw professional advice was incorporated into care planning and delivery.
The registered manager displayed a good understanding of capacity and the need for consent throughout care practices. We saw one person had been supported to receive the support of an advocate.
People’s changing needs were identified and met through liaison with a range of external health and social care professionals and we saw these interactions were clearly documented.
We saw the majority of complaints were comprehensively responded to, with one not being responded to by the registered manager – they undertook to rectify this. People we spoke with and relatives told us they knew how to make a complaint if they needed to, and to whom.
Staff, people who used the service, relatives and other professionals praised the support they received from the registered manager and we found the registered manager and nominated individual to have a good corporate oversight of the organisation, as well as a knowledge of people who used the service.
We saw the registered manager had in place a range of audits to identify areas of concerning practice. We saw where discrepancies had been identified these had been addressed and communicated to staff.