Outstanding responsive domiciliary care
Outstanding responsive domiciliary care – The Care Quality Commission carried out an inspection of Gardiner’s Homecare from 8 to 10 September 2015. This comprehensive inspection was to check whether we were 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.
How the inspection was conducted
Prior to the inspection the CQC contacted the local authority and also referred to any notifications sent to them by Gardiner’s to advise of any significant events related to the service. During the inspection the CQC spoke with service users, care workers, care managers, the registered manager and managing director.
The inspector reviewed Care Plans and other relevant care documentation. In addition the inspector reviewed other records relating to the management of the service, including staff records, complaints and quality assurance assessments.
What the inspector reported – Overall Good and Outstanding responsive domiciliary care
The CQC found that staff knew how to keep people safe by reporting concerns promptly. Systems and processes were in place to recruit suitable staff and to protect people against the risk of abuse. Staff were matched to meet people’s needs as per experience, knowledge, age and general personality.
Service users said they were very happy with the support and care provided. Service users confirmed they were fully involved in the planning and review of their care. Care plans focused on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively.
The CQC were told that communication with the service was good and they felt listened to. All people spoken with said they thought people were treated with respect, preserving their dignity at all times. They were confident to recommend Gardiner’s stating that this was an “outstanding” domiciliary care service.
The report continued …
People were supported with their medicines by suitably trained staff. Medications were managed safely and securely. The CQC raised the issue of PRN (as and when) medication and were assured the perosnalised protocols for each PRN medication would be written as priority.
People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests.
People received care and support from staff who had exceptional skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced members of staff. Gardiner’s had created a room to replicate a person’s to whom support is provided and used this to train staff in moving handling. Using live examples provided evidence of personalisation in training, staff reported that this was useful when working with people. Staff reported feeling supported by the registered manager and said they were listened to if they raised concerns.
The quality of the service was monitored regularly. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. Outstanding responsive domiciliary care.
Findings – Overall Good & Outstanding responsive domiciliary care
Outstanding – The service was responsive
- Care plans reflected people’s needs and were reviewed regularly. People’s views were listened to and acted upon.
- There was a system to manage complaints and people and relatives felt confident to make a complaint if necessary.
- People and their relatives were asked for their views on the service and they felt confident to approach the management with concerns.
- The service was responsive to people’s changing needs. Staff responded to people’s needs, going above and beyond their agreed hours of support and care, if they felt this was required during a visit.
Good – The service was caring
- Staff worked in a caring, patient and respectful way, involving people in decisions where possible. They respected people’s dignity and privacy.
- Staff knew people’s individual needs and preferences well. They gave explanations of what they were doing when providing support. They remained with people when a person’s health was noticeably at risk, even if this exceeded the agreed hours of support.
Good – The service was effective
- People and their relatives were involved in making decisions about their care.
- Where people did not have capacity to make decisions, support was sought from family members and healthcare professionals in line with legal requirements and safeguards.
- People were supported with meals and drinks of their choice that met their dietary needs and when necessary people were supported to eat and drink.
- People received timely support from appropriate health care professionals.
- Staff received regular supervision, training and appraisals.
Good – The service was safe
- People were safeguarded from abuse and staff understood how to report any concerns they had. Procedures were available in the office for quick reference.
- The provider had a strong recruitment procedure in place. People were kept safe with the current staffing ratios, and the teaming of staff to peoples needs. Medicines were managed safely.
Good – The service was well-led
- Staff, relatives and professionals found the management approachable and open.
- Effective processes were in place to monitor the quality of the service. Audits identified where improvements were required and action was taken to improve the service.