START

Updated 20 October 2018

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 comprehensive inspection took place on 1 and 2 October 2018 and was announced. It was carried out by two adult social care inspectors on the first day and one inspector on the second day. We gave the provider 48 hours’ notice of the inspection as we needed to make sure we were able to access records and gain permission from people who used the agency to speak to them.

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 service, what the service does well and improvements they plan to make. We looked at the information in the PIR and also looked at other information we held about the service before the inspection visit. We also looked at notifications sent in by the service. A notification is information about important events which the service is required to tell us about by law. We used this information to plan the inspection.

We spoke with five people who used the service on the telephone and two relatives. We met with two care staff and spoke with three further care staff on the telephone. We met the registered manager and two members of the provider’s senior management team.

We looked at a sample of records relating to the running of the agency and the care of individuals. These included the care records of four people who used the agency. We also looked at records relating to the management and administration of people’s medicines, health and safety and quality assurance. We checked two staff recruitment files and staff training and supervision records.

Updated 20 October 2018

This inspection took place on 1 and 2 October 2018 and was announced. We gave the provider 48 hours’ notice as we needed to be sure somebody would be available in the office. The first day of the inspection was spent at the agency’s office and on the second day we spoke with people who used the service on the telephone.

START is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to people who are living with dementia, learning disabilities or autistic spectrum disorder, older people, younger adults and people who have a physical disability and/or sensory impairment. Not everyone using the agency receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.

At the time of this inspection 15 people were receiving assistance with their personal care needs.

START provides a short-term assessment and re-enablement service (maximum six weeks) to people who are discharged from hospital and to prevent admission to hospital.

This was the agency’s first inspection since it registered with the Care Quality Commission in July 2017.

There was a registered manager in post. 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.

The registered manager had been in post since September 2018.

People felt safe. People were protected from the risk of harm or abuse because the provider had effective systems in place which were understood and followed by staff. People were supported with their medicines by staff who were trained and competent in their role. There were sufficient staff to meet people’s needs in a safe and unhurried way. The provider ensured staff were suitable to work with people. Staff knew the procedures to follow should they did not get a response when visiting a person’s home. The procedures for identifying and managing risks helped to ensure people were safe.

People received effective care. People were supported by staff who were trained and competent in their roles. People’s health care needs were monitored. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by kind and caring staff who took time to get to know people and what was important to them. Staff treated people with respect and respected their right to privacy. People were supported to achieve their goals and reach their full potential.

People were involved in planning and reviewing the care they received which helped to ensure people received a service which met their needs and preferences. People’s religious and cultural needs were understood and considered by staff. Information was available in accessible formats where required. There were procedures in place to ensure people had access to the equipment they needed to promote their independence. People knew how to complain if they were unhappy with the support they received.

The registered manager was committed to ensuring people received a high standard of care. The provider had effective systems in place to monitor and improve the quality of the service provided. People were supported by a team of staff who felt supported and valued. People’s views were valued. The registered manager worked closely with other professionals to ensure the best outcomes for people who used the service.