At Home

Updated 9 May 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.

The inspection took place on the 10 April 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

The inspection team consisted of one 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.

On this occasion we did not ask the provider to complete 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 information we held about the service. This included notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted six health and social care professionals involved in the service for their feedback and received feedback from two regarding the service.

During our inspection we spoke with six people and three relatives over the telephone, four personal assistants, an administrator, the co-ordinator, branch manager and the integrated services manager. We observed the managers and staff working in the office dealing with issues and speaking with people over the telephone.

We reviewed a range of records about people’s care and how the service was managed. These included the care records for five people, medicine administration record (MAR) sheets, five staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.

The service was last inspected on the 5 July 2106 and was awarded the rating of Good. At this inspection the service remains Good.

Updated 9 May 2018

The inspection took place on the 10 April 2018 and was announced. The provider was given 48 hours’ notice because the location provides a care at home service. We wanted to be sure that someone would be in to speak with us.

Montague House is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and provides a service to adults. On the day of the inspection the service was supporting fifteen people with a range of health and social care needs, such as people with a physical disability, sensory impairment or people living with dementia. Support was tailored according to people’s assessed needs within the context of people’s individual preferences and lifestyles to help people to live and maintain independent lives. Staff who supported people using the service were also known as personal assistants.

At the last inspection on5 July 2016, the service was rated as good in the areas of Effective, Caring, Responsive and Well-led. The service was rated as requires improvement in the area of Safe but the overall rating for the service was Good. At this inspection we found the evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The new manager had been monitoring the quality of the service by the use of visits to people’s homes and internal quality audits they had introduced. Where these had been recently introduced by the manager they were not fully completed and information was not consistent. People and staff felt that they were not receiving effective communication about any changes that had been, and were, taking place. We identified this as an area of practice that needed to improve.

People and relatives told us they felt the service was safe. The provider had made improvements to their systems for recruitment to ensure that staff were suitable to work with people. People remained protected from the risk of abuse because staff understood how to identify and report it. People continued to receive their medicines safely. The provider had arrangements in place for the safe administration of medicines. People were supported to maintain good health and had access to health care services

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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 at mealtimes to access food and drink of their choice. Some people’s food preparation at mealtimes was supported by staff or themselves, staff ensured meals were accessible to people.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment when required.

Staff continued to have the knowledge and skills to support people. There was an induction process and a training plan in place for essential training such as, safeguarding and health and safety. Staff also received training updates when required and supervision.

People and relatives felt staff were kind and caring. Staff spoke warmly about the people they supported and provided care for. Staff were able to detail people's needs and how they gave assurance when providing care.

Further information is in the detailed findings below