19 October 2017
During a routine inspection
The service had 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.
People and their relatives provided good overall feedback about the service, particularly about the caring nature of their regular staff. However, some told us timekeeping was an issue as staff were not always arriving when they were expected. We found visit scheduling arrangements were not always robust enough to ensure people consistently received expected care visits on time. However, no-one reported visits were being missed, and it was clear that the service provided people with the same staff members where possible.
The service supported people well with ongoing healthcare matters. There was effective collaborative working with healthcare professionals, in part due to the registered manager’s previous experience of community nursing. People were supported to have comfortable and dignified end-of-life care where this was needed.
The service assessed and managed risks relating to care delivery in people’s homes. This included for safe support with medicines, hoisting, and nutrition where part of agreed the care package.
People were supported to express their views and make decisions about their care and support. Consent to care was sought in line with legislative principles. Care plans were in place to formalise the process.
People received care and support from staff who responded to their individual needs and preferences, and who had the knowledge and skills needed for their care roles. The service listened to and learnt from people’s concerns and complaints, and responded well when further care support was needed as the registered manager knew people well and provided hands-on support at short notice where needed.
The service had systems to help protect people from abuse and ensure safe staff recruitment practices occurred.
The provider asked people’s views on how the service operated so as to improve, and promoted a positive working culture for staff. Audits of care records had been embedded, to help ensure good quality care was occurring. However, there were no documented arrangements for oversight of quality checks of staff and quality visits to people using the service, to ensure these covered everyone. In conjunction with the staff visit scheduling concerns, this demonstrated the service was not consistently well-led.