Background to this inspection
Updated
11 September 2015
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.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
Before the inspection we reviewed all of the information we held about the service, this included reviewing notifications we had received. We spoke to the local authority contracts and commissioning team, and contacted Healthwatch. Healthwatch represents the views of local people in how their health and social care services are provided.
The inspection team consisted of one inspector; who visited the office and then met with the people who used the service in their own home. They were unable to verbally communicate with us so we observed the interaction with support staff. We offered their relative, who was their main carer, an opportunity to give their view on the service. They did not get back to us.
We looked in detail at the two support plans, and a staff manual which contained practical information about supporting the people in their own home.
We spoke to the registered manager and three support workers. We looked at three staff files. We looked at documents and records that related to people’s care and support, and the management of the service such as rota’s, training records, audits, policies and procedures.
Updated
11 September 2015
This inspection took place on 17 July 2015. We announced the inspection as it is a domiciliary care service and we wanted to be sure there would be someone available at the location office to see us.
The service registered in August 2013 and had not been inspected previously.
The organisation had two small residential homes, as well as the domiciliary care service, for people with learning and physical disabilities, and those on the autistic spectrum. This is relevant to this inspection as staff from these services also provide support for people using the 24 Villa Close service when required.
24 Villa Close registered to provide personal care in people’s own home in August 2013 and initially provided support to younger adults with physical and learning disabilities and to older people living with dementia. The maximum number of people the service supported was 10. However, the provider decided to focus on support to younger people. They now provide support to two young people, who live at the same address. They currently provide 110 hours of support per week. The registered manager advised they are not currently taking any new customers for domiciliary care.
The service has a registered manager, who also manages the two small residential services the organisation runs.
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 service had enough staff to deliver the support needed. Staff were flexible and provided additional support when this was required. Some support staff had accompanied people and their carers on holidays. Staff had been recruited safely.
People had detailed risk assessment and management plans in place and staff knew how to respond in an emergency. There were clear protocols in place for the administration of rescue medicines.
Staff had been trained to administer medicines safely and the service had a medication policy for staff to refer to.
Staff understood the importance of how to protect people from avoidable harm, the service had a safeguarding policy and staff could tell us about types of abuse and, although they had never had to, they knew how to raise concerns.
Staff had received effective training. This included a comprehensive induction period and ongoing training. All of the staff we spoke with told us they felt well supported by the registered manager.
Staff understood the principles of the Mental Capacity Act 2005 (MCA) and we could see they were applying this legislation. However, we did not see any record of MCA assessments or best interest decisions.
People had support to access a healthy balanced diet.
Staff sought support and guidance from relevant health care professionals.
Staff were kind and compassionate and it was evident there was a good rapport between staff and people who used the service. Staff stressed the importance of supporting people to have a good life and helped people take part in a variety of activities.
People received personalised support which was responsive to their needs. Support plans contained detailed information and were person centred.
Although there were some gaps in support plans this did not have an impact on people because their core staff team knew them so well. The registered manager had already started to address these gaps.
The registered manager was aware areas where further development was required. Record keeping required improvement. We have made a recommendation regarding this.
The service had effective systems in place to monitor the quality of support people received. The registered manager was keen to develop the service with the aim of ensuring people received the best support.