Knowsley and Liverpool East Office

Knowsley and Liverpool East Office is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of the inspection the registered provider was providing support to 18 people.

At the time of the inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the registered provider was recruiting into the role of registered manager.

At the previous comprehensive inspection which took place in November, 2016 the registered provider was rated 'Requires Improvement'. We found the registered provider was not meeting legal requirements in relation to 'Safe Care and Treatment' and 'Need for Consent'.

During this inspection we found that a number of improvements had been made and the registered provider was complying with all health and social care regulations.

There were a number of different systems in place to assess and monitor the quality of the care being provided. This meant that people were receiving safe, compassionate and effective care. Such systems included weekly and monthly governance meetings, quality audits, care plan and medication audits as well as annual quality questionnaires.

Care plans and risk assessments which we reviewed were well maintained, regularly reviewed and updated in order to minimise risk and ensure the correct level of support was being provided.

Care plans were individually tailored to each person who was being supported and a person centred approach to care was evident throughout the inspection. Person centred means care which us tailored around the needs of the person, not the organisation. Staff were familiar with the support being provided and people's wishes, choices and preferences were well known.

Medication management systems were being safely managed. Staff had received the necessary medication training. People had the relevant medication care plan and risk assessments in place which included detailed information about how medication administration needed to be supported.

Recruitment processes were reviewed during the inspection. All staff who were working for the registered provider had suitable references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enables

the registered manager to assess level of suitability for working with vulnerable adults.

Staff received regular supervisions and annual appraisals. Staff expressed how they were fully supported in their roles; all necessary training had been completed and they felt that they were able to fulfil their roles effectively.

There was a system in place to monitor and assess all accidents and incidents. These were recorded on an internal database system, trends were analysed on a weekly and monthly basis which then helped the registered provider to establish trends and risks which needed to be managed.

The day to day support needs of people were well managed by the registered provider. Appropriate referrals were made when needed and the relevant guidance and advice which was provided by professionals was being followed accordingly.

The registered provider was aware of their responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with CQC's statutory notifications procedures.

We reviewed a range of different policies and procedures which were in place. Policies and procedures were up to date, contained relevant information and were available to all staff as and when they needed them. Staff were familiar with the area of 'safeguarding' and 'whistleblowing' procedures. Staff knew how to report any concerns and had completed the necessary safeguarding training.

The five questions we ask about services and what we found