22 May and 10, 26 June 2014
During a routine inspection
Our inspection team was made up of one inspector. We gathered evidence against the outcomes we inspected to help answer the five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
We looked at a range of records, spoke with the registered manager and two directors. We also spoke with four staff of varying roles. We visited and spoke with two people in their own homes and spoke with three relatives of people who use the service.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the manager and staff.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We saw that there were systems in place to keep people safe. People were provided with good levels of staffing, with sufficient time for their care to be delivered in a person centred way and in a way that kept them safe.
Senior staff completed pre service assessments prior to the service providing any care or support to people. This ensured that the service was able to meet people's needs.
Support plans and risk assessments were in place and were updated as people's needs changed. Care records detailed the support people required and encouraged people to be independent where possible. People we spoke with during the inspection told us that they were confident with the staff who provided them with care and support.
Support plans also detailed the equipment that people used. There was evidence to show that appropriate checks were carried out on equipment to ensure that it was safe to use. People also said that where equipment was used they felt that staff had the required training and knowledge and used the equipment safely.
There were systems in place within the office to ensure that equipment owned by the service was maintained, this including portable appliance testing.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care home. The service had proper policies and procedures in relation to safeguarding vulnerable adults. The manager had a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards and staff had received training in respect of safeguarding vulnerable adults.
Is it effective?
People all had their needs assessed and had comprehensive individualised support plans in place, which clearly set out their care needs. It was clear from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well.
People who used the service and staff confirmed that they had access to the equipment they needed to provide the required support.
Is it caring?
People we spoke with told us that they were provided with very good care and support. They told us that they were treated with dignity and respect and that the staff were very professional.
People's needs had been assessed and support plans put in place which detailed people's needs and preferences. These records provided comprehensive information to staff on what care and support people who used the service needed.
Care and support had been provided in accordance with people's needs.
Is it responsive?
There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals. We saw lots of evidence of multi-agency working.
It is well led?
The service had a registered manager, who is one of the directors. They were supported by two other directors, all three who were involved in the day-to-day running and management of the service. There were systems in place to assure the quality of the service they provided.
Staff had a good understanding of the ethos of the service and were clearly knowledgeable about individual people's needs. This helped to ensure that people received a good quality service at all times.
What people told us.
We visited two people in their own homes and spoke with three relatives on the phone. Everyone we spoke with were highly complementary about the care and service provided. They said that the service provided continuity of care, with them being able to get to know the staff who worked with them.
People said that the service was reliable and punctual.
Comments people made included, "I am happy with the service and I can't think of anything that would improve it." "Service is wonderful, they are all wonderful, can't do enough for you." "It is a really good company, definitely the right attitude and manner."
People were aware of their support plans and confirmed that staff referred to the information and completed a log at each visit.
Relatives said, "I am happy with them and they treat her with dignity and respect." "They really are great, lovely, best we have ever had."