Care Together Limited - 1st Floor The Corner House

Updated 18 December 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 was carried out by 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.

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 19 September 2019 and ended on 25 September 2019. We visited the office location on 23 and 25 September 2019.

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 reviewed information we already held about the service and sought feedback from health and social care professionals. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and eight relatives about their experience of the care provided. Many people had a relative or friend who spoke about their service due to their condition. We spoke with four members of staff including the registered manager, deputy manager, and care staff. The registered manager was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people’s care 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

After the inspection we were contacted by two staff members who wanted to share their experiences of working for the provider with us.

Updated 18 December 2019

About the service

Care Together Limited – 1st Floor the Corner House, is a domiciliary care service providing personal care to 11 people aged 65 and over at the time of the inspection.

The provider was located centrally in the village with other amenities such as the post office and shops. People and their relatives regularly visited the provider when accessing other village facilities.

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

The service was exceptionally safe. Staff had in depth knowledge of safeguarding and participated in regular training updates. Risks were assessed and actions to minimise unnecessary risks were put in place, however people were enabled to take calculated risks in order to lead fulfilling lives.

Medicines were safely managed and there were clear procedures should errors occur. Staff were safely recruited through scenario-based interviews to ensure they would reflect the values of the service in practice. The provider was constantly updating training in infection control and was creative in their approach.

The provider was exceptionally skilled at achieving positive outcomes for people they supported. Detailed assessments of needs ensured that care plans reflected relevant outcomes and people’s needs under the Equality Act 2010. People were involved in the development and review of their care plans.

Staff were exceptionally well supported through regular supervisions and an extensive package of training. Support was given to staff to develop skills and the provider linked to other services in the area in order to access training that, as a small provider would not be cost effective to purchase.

Support with nutrition was creative, staff prepared meals for and ate with some people, took others out to cafes and lunch clubs and made comprehensive recordings to monitor food intake.

Very positive links had been forged with health and social care professionals and other service providers. This ensured that people had a seamless service when moving from hospital to home for example.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives told us that the service was exceptionally caring and respectful. A group had been set up for bereaved relatives of people the service had cared for which had been opened up to relatives of people who had a poor medical prognosis.

A 24-hour on-call system enabled people to call for assistance at any time. Staff would often attend to someone during the night should they need personal care, or chat with them if they were upset. Priority was given to spending quality time with the person rather than completing a chore such as the washing up as the person may not see anyone else until their next care call.

New staff did not support people until the registered manager was assured they understood their role in maintaining people dignity. People and their relatives told us that staff were dedicated to ensuring people had quality of life.

The provider supported some people to transition to having care at home by providing domestic support in the home and gradually adding support with personal care. The provider was exceptionally responsive to emergencies and would adjust care calls to support people if they became unwell or needed additional support unexpectedly.

The provider offered a range of activities and supported people to access community events. They had been involved in setting up a dementia friendly ballroom class and regularly fundraised to provide additional activities for people such as visiting a local motorcycle museum.

Relatives told us they had been very well supported during the end of life care of their family members and the registered manager was proud of the way they supported people. For example, when a person had died, they would be dressed in a favoured outfit and items that meant a lot to them arranged with them. This had been comforting to relatives.

People and their relatives told us the service was exceptionally well-led, the manager and deputy manager received only positive feedback. The provider had been shortlisted for and received a number of care awards. Staff contacted us after the inspection to tell us how proud they were of the service and the support they received and provided.

The provider was holistic in their approach, though providing a service to one person, they would consider everyone in the household, the environment and support people in making future plans. The provider was committed to providing quality care and if unable to meet the specific needs of a person would signpost them elsewhere.

People and staff participated in quality assurance surveys. The registered manager was doing extensive work to develop new ways to obtain feedback as surveys were unpopular with people.

The provider had positive professional relationships with health and social care professionals, local businesses and care homes and were well known in the local community.

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 outstanding (published 21 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Together Limited – 1st Floor the Corner House on our website at www.cqc.org.uk.

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.