Background to this inspection
Updated
5 March 2020
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 was carried out by one inspector and two Experts 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary care service and we needed to be sure the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 31 January 2020 and ended on 05 February 2020. We visited the office location on 31 January 2020.
What we did before the inspection
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 also reviewed the information we held about the service. This included any statutory notifications received. Statutory notifications are specific pieces of information about events, which the provider is required to send to us by law.
We sought feedback from the local authority contracts monitoring and safeguarding adults' teams and reviewed the information they provided. We also contacted the local Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and 10 relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager.
We reviewed a range of records. This included seven people’s care records and medication records. We looked at four 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.
Updated
5 March 2020
About the service
City Care is a domiciliary care agency providing personal care and support to people living in their own homes. 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. At the time of inspection 210 people were receiving personal care.
People’s experience of using this service and what we found
People and their relatives were very complementary about the service and the support provided by staff. Relatives told us how much a positive effect the staff had on people. One relative commented, “From [Person’s name]’s point of view, the carers have improved her quality of life. She has more interaction, physically she is better… it means she can stay in her own home, which is where she wants to be. I cannot praise them enough.”
Staff provided care and support to people which made them feel safe. Relatives told us staff were kind and caring with people. Staff knew people well and worked together to provide a continuous level of care. People were treated respectfully by staff.
People were encouraged to remain independent within their own homes. People were supported to access the local community and staff provided social interaction to remove the risk of isolation. Staff provided people with choices about their care and involved relatives with this.
Staff encouraged and supported people to have maximum choice and control of their lives, including supporting people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Medicines continued to be managed safely. Risks to people had been fully assessed and mitigated. Care needs were assessed regularly, and people were consulted and involved in all aspects of their care. Staff continued to be recruited safely
Staff received regular training, supervisions and team meetings. There were enough staff to safely support people. Staff had their competencies checked regularly and were provided with an induction when they joined the service. People (where required) were supported to eat a balanced diet. People were referred and supported to access other healthcare professionals including their GP.
The registered manager and office staff were working on continuously improving the service provided. There were quality assurance systems in place to monitor the quality of care provided to people. This system was being reviewed to make sure all audits of the service were fully effective to drive improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 31 August 2016).
There was also an inspection on 17 January 2019. However, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
Why we inspected
This was a planned re-inspection because of the issue highlighted above.
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.