Background to this inspection
Updated
26 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 1 October 2019 and ended on 3 October 2019. We visited the office location on 3 October 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and eight relatives about their experience of the care provided. We spoke with nine members of staff including the operations manager, area manager, registered manager, a deputy manager, a field supervisor and four care workers.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate the evidence found. We looked at audit records and quality assurance data.
Updated
26 November 2019
About the service
Homecare4U Staffordshire is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of inspection, the service was providing support to 44 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People did not always receive personalised care that was appropriate to meet their needs. People’s call times were regularly late and inconsistent and call times were not provided in line with people’s preferences.
People were not always supported by staff who the provider had ensured received adequate training to ensure they could provide consistent care.
People were supported to have maximum choice and control of their lives and staff mostly supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not always support this practice. For example, staff did not always understand the principles of the Mental Capacity Act and the provider did not complete their own mental capacity assessments.
People’s end of life wishes were not always discussed with them if they were not at the end stage of their life so their preferences were not known.
Some actions identified by audits undertaken to check the quality of the service were not always addressed immediately. Staff told us that communication was poor and they did not always feel heard when they raised concerns.
People were safe. Systems were in place to protect people from abuse. Risks to people were identified and staff understood how to manage risks effectively. Medicines were administered safely and medicine errors were addressed appropriately when needed. People were supported by staff who used appropriate Personal Protective Equipment (PPE) and understood how to reduce the risk of infection. People were supported by safely recruited staff. When things went wrong and people’s safety was put at risk, action was taken to address this and reduce the risk of similar occurrences happening again.
People’s needs and choices were assessed and reviewed when needed. People were supported to maintain a balanced diet in line with their care plans. People were supported to access healthcare support when needed and referrals were made in a timely manner.
People were supported by kind and caring staff. People were encouraged to express their views and be involved in making their own decisions. People were encouraged to be independent and do what they could for themselves. People’s privacy and dignity was respected by staff.
People’s communication needs were considered and staff communicated with people in a way they understood. People were supported by staff who engaged and built rapport with them to try to reduce their social isolation. People’s concerns and complaints were listened to by the manager, investigated and action taken where needed.
Audit systems in place were mostly effective in checking the quality of the service. The manager understood their responsibilities and statutory notifications were submitted to CQC as required by law. People, relatives and staff were encouraged to provide feedback to improve the service. The registered manager had identified areas for learning and was taking steps to improve the quality of care provided. The service worked closely with other agencies to ensure people’s needs were met.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 29 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.