Individual Homecare Services

Updated 7 March 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 checked 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 19 December 2017 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity took place on 19 December 2017. We visited the office location to see the deputy manager and office staff; and to review care records and policies and procedures. Prior to the inspection we carried out telephone interviews with people and a relative to gain their views about the quality of the care provided.

The inspection team consisted of an 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. The Expert by Experience carried out the telephone interviews with people prior to the office based inspection.

On this occasion, we had not asked the provider to send us a provider Information return (PIR). A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant. We reviewed other information we held about the home, which included notifications they had sent us. A notification is information about important events which the provider is required to send us by law.

We also contacted local authority commissioners of adult social care services and Healthwatch and asked them for their views of the service provided.

During the inspection we spoke with seven people who used the service and one relative. We also spoke with two members of the care staff and the deputy manager. After the inspection we gave the registered person the opportunity to respond to our findings, which they did.

We looked at all or parts of the records relating to five people who used the service as well as three staff recruitment records. We looked at other information related to the running of and the quality of the service. This included quality assurance audits, training information for care staff, staff duty rotas, meeting minutes and arrangements for managing complaints.

We asked the deputy manager to send us a copy of their training matrix, which they did prior to this report being completed.

Updated 7 March 2018

We carried out an announced inspection of the service on 19 December 2017. Individual Homecare Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Individual Homecare Services 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. Where they do we also take into account any wider social care provided.

The service is operated by an individual and so does not require a registered manager. The registered provider is the 'registered person.' 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 provider had employed a manager, referred to in this report as the deputy manager, who supervised the day to day running of the service.

Individual Home Services currently supports 13 people who receive some element of support with their personal care. This is the service’s first inspection under its current registration.

People were protected against the risks of experiencing avoidable harm. Staff could identify the potential signs of abuse and knew who to report any concerns to. Assessments of the risks to people’s safety were carried out although the reviewing of these assessments needed to be completed more frequently. People told us they felt safe when staff supported them. People were supported by an appropriate number of staff to meet their needs. Safe recruitment procedures were in place, although a small number of staff carried out shadowing shifts prior to the results of their criminal record checks being received. This process was amended immediately after the inspection. Where people needed support with their medicines staff did so safely. Assessments of the environment people lived in were carried out to ensure they were safe. Staff had completed infection control training that enabled them to identify any potential infection control risks in people’s homes. Accidents and incidents rarely occurred, however processes were place that ensured they were investigated appropriately.

People’s physical, mental health and social needs were assessed and provided in line with current legislation and best practice guidelines. People were supported by staff who had completed a detailed induction and training programme and had their performance reviewed. Staff felt supported by the deputy manager and the registered person. Where people received support with their meals staff did so effectively. The deputy manager and the registered person had built effective relationships with external health and social care organisations to aid with providing people with effective healthcare. 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 support this practice.

People felt staff were caring, treated them with respect and dignity and listened to what they had to say. Staff showed a genuine interest in building positive relationships with people. Staff were knowledgeable about their needs and where able people or their relatives were involved with making decisions about their care. People’s diverse needs were respected. People were encouraged to do things for themselves. Following the inspection, people were provided with information about how they could access independent advocates. Care staff communicated effectively with people.

Prior to starting with the service people’s needs were assessed to determine whether the service could meet those needs. People and their relatives were involved with agreeing the level of care and support they would receive when they started to use the service. Care records contained detailed, person centred guidance that enabled staff to respond to people’s individual preferences. People were treated equally, without discrimination and systems were in place to support people who had communication needs. A small number of people felt communication with the office based staff could be improved. People felt able to make a complaint and that it would be dealt with appropriately.

The service was well led by a dedicated, enthusiastic and caring deputy manager, who managed the day to day running of the service for the registered person. Although the registered person was not always present at the service, twice daily contact was made with the deputy manager to ensure any issues or concerns were discussed and actions agreed. The deputy manager felt supported by the registered person to carry out their role and was in the process of becoming registered with the CQC. People spoke highly of the deputy manager. The provider’s aims and values were respected by staff who in turn provided people with the support they needed. People felt their views mattered. A formal questionnaire to gain people’s views for the previous calendar year was about to be sent out. The deputy manager continually looked to improve the service provided and expanded their knowledge by attending locally run forums. Quality assurance processes were in place and these were effective.