Background to this inspection
Updated
7 July 2016
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 inspection took place on 10 May and was announced. The inspection continued on 11 May and 18 May 2016. The provider was given 48 hours’ notice. This is so that we could be sure the manager or senior person in charge was available when we visited. The inspection was carried out by a single inspector.
This was the first inspection that the service had had since registering with CQC. Before the inspection we looked at notifications we had received about the service. We spoke with the local authority contract monitoring team to get information on their experience of the service.
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 spoke with three people who use the service and two health care professionals who both had experience of the service provided feedback during our inspection.
We spoke with the registered manager, locality manager, a service manager and a team leader. We met with three care staff. We reviewed five people’s care files, policies, risk assessments, quality audits and the 2015 quality survey results. We visited two locations and met with three people in their own homes. We observed staff interactions with people and part of a locality managers meeting. We looked at five staff files, the recruitment process, staff meeting notes, people’s house meeting notes, training, supervision and appraisal records.
Updated
7 July 2016
The inspection took place on 10 May and was announced. The inspection continued on 11 May and 18 May 2016.
There was a central office which had three separate offices, a training room, toilet and small kitchenette.
Personal care was provided to 10 people at four separate locations. One location was a supported living set up where people lived in their own flats. Two locations were shared supported living set ups and there was one domiciliary service where staff supported people living in their own homes in the community.
The service had a registered manager in place. 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.
One person with mobility needs had not had an occupational therapist assessment for access in and round their home. There were no support rails around the flat to support them to move freely and safely around the home. The registered manager acknowledged this and told us they would prioritise a referral to the OT team.
Staff records did not hold up to date induction records or work permit information. The registered manager followed these up during our inspection and identified that the staff member was working with the team leader to complete their induction record and a staff member was in process of renewing their work permit. The registered manager said that these records will be placed in their staff records as soon as they were completed and that an audit of all staff files is currently taking place.
People, staff and health professionals told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding adults.
Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they choose to live their lives. Each person had a care file which also included guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.
Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines.
Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, autism, epilepsy and learning disability.
Staff told us they received regular supervisions and appraisals which were mostly carried out by the service manager and team leader. We reviewed records which confirmed this. A staff member told us, “I receive regular supervisions”.
People had a capacity assessment in place and care files we reviewed showed evidence of best interest meetings taking place. Staff were aware of the Mental Capacity Act and training records showed that they had received training in this.
Some people were supported with cooking and preparation of meals in their home. People were supported to choose meals through weekly menu planning meetings. The training record showed that staff had attended food hygiene training.
People were supported to access healthcare appointments as and when required and staff followed GP and District Nurses advice when supporting people with ongoing care needs.
People and relatives told us that staff were caring. During home visits we observed positive interactions between staff and people.
A health professional said, “Staff are good at communicating information, they use visual prompts”. They went onto tell us that they had seen staff supporting people in the community and that people looked relaxed and happy in staffs company.
Staff we observed treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes, interests and communication needs. A health professional told us, “Staff seem to have good knowledge of peoples care and support needs”.
People had their care and support needs assessed before using the service and care packages reflected needs identified in these. We saw that these were regularly reviewed by the service with people, families and health professionals when available. People and relatives told us that they were involved in reviews.
People, staff and relatives were encouraged to feedback. We reviewed the staff and client satisfaction survey report for 2015 which contained mainly positive feedback. This report reflected results from feedback questionnaires sent to relatives and professionals. The results had been analysed and actions were set for the registered manager to follow up. We saw that the actions identified from this had been addressed.
There was a system in place for recording complaints which captured the detail and evidenced steps taken to address it. We saw that there were no outstanding complaints in place.
Staff had a good understanding of their roles and responsibilities. Information was shared with staff so that they had a good understanding of what was expected from them.
People, staff, relatives and health professionals all felt that the service was well led. The manager encouraged an open working environment. A staff member told us, “The registered manager is a good leader. They are approachable and professional”.
The service understood its reporting responsibilities to CQC and other regulatory bodies and provided information in a timely way.
Quality monitoring visits at the locations were completed by the registered manager and audits completed by the service manager and team leader. The registered manager logged data from incident reports monthly which included medication errors, incidents, complaints or falls to name a few. This data was then logged onto an on line system which analysed the detail and identified trends and learning which was then shared.
The Regard Partnership had recently received a Gold award in the Investors In People (IIP) programme. Regard Southern Regional Office had also been quality checked by people first and was found to be meeting the REACH standards.