Martlets Hospice

Martlets Care is a domiciliary care service providing personal care people in their own homes. People supported were either over 65 or were living with disabilities such as motor neurone disease or dementia. 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 the inspection 98 people were receiving personal care, and included privately and publicly funded clients.

People’s experience of using this service and what we found

People told us they felt safe and staff were knowledgeable about the care they were expected to provide. The registered manager understood risk management and had policies in place to keep people and staff safe. A relative told us “They’ve been fantastic, I can trust them, they’ve become friends, they support the family.”

People were supported to remain as independent as possible. Care people received was personalised and designed around the life they led. Staff were recruited and trained appropriately, including in the administration of medicines. Staff were well trained and where a person had complex needs, staff had further training to ensure they could provide effective care. A person told us “Staff are very informed about things.”

People spoke highly of the care they received. A person told us “I’ve been in a nursing home and the care you get there is nothing like the care I get now!” and a relative told us “They are not patronising. They have a laugh with her. They don’t tell her what to do.” Staff told us that dignity in care was important.

People had care plans that were regularly reviewed. People and their relatives were involved in any planning and were at the centre of the care. Complaints were few and acted on quickly. A recent survey included the comment “The care over the past few years has been excellent. Without the personal care, mum wouldn't be here today."

The service was well-led by a registered manager who was keen to ensure compassion in care. Staff were happy and proud to work for the service and the positive attitude of the team showed in the care people received. One person said, “They are all the same, all very friendly, always smiling.”

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection.

We last inspected this service 16 September 2016 and the rating was Good.

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 Martlets Care on our website at www.cqc.org.uk.

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.

Martlets Care is a domiciliary care agency and provides personal care and support for adults and older people living in their own home in the Brighton and Hove and Havens area. At the time of our inspection around 80 people were receiving a service. The agency is registered to provide nursing care and personal care. At the time of the inspection only personal care was being provided. The service is part of the Martlets Group of services, which supports the Martlets Hospice.

On the day of our inspection, there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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. However, the registered manager was not present during the inspection. The nominated individual for the organisation was present during the office visit.

There was a clear management structure with identified leadership roles. The registered manager undertook people’s assessments and reviews and was supported by a care supervisor who undertook the staff supervision and appraisals and coordinated staff training. Both had the support of a senior care coordinator assisted in the completion of the tasks. An office manager managed the care coordinating team who worked on setting up new care packages, care matching (allocating people to care staff to provide the care call), managing the capacity to take on new care packages, and ensuring peoples care visits were covered, auditing medicines administration records and care record sheets.

People told us they felt safe in the service. People were supported by care staff who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. Care staff had been through safe recruitment procedures. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

There was a detailed care and support plan in place for each person accompanied by supporting risk assessments. Care and support provided was personalised and based on the identified needs of each individual. People told us people always got their care visit, they were happy with the care and support provided. People were supported by kind and caring staff. People’s privacy and dignity was considered when care and support was provided. People received care from kind and caring care staff. One relative told us, “The carers do things above and beyond their expected tasks. They change my mum but also put things in the washing machine to save me a job. That is consideration.”

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.

People were supported to eat a healthy and nutritious diet. People had access to health care professionals and had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. Medicines were managed safely and people received the support they required from care staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

There was a compliments and detailed complaints procedure. Compliments received included, ‘You all helped make my life a lot easier. I actually got a good nights sleep and got out occasionally, to met up with friends or go shopping,’ and ‘Thank you (Registered Manager) and (Staffs name) and all in the office, who cleverly managed our ever changing care package.’

The management team provided good leadership and support to the care staff. One member of staff told us, “We are well supported by the HR team, and manager and the manager is accessible. They are available and get straight back. They make sure we take time to care and allow time to care.” Another member of staff told us,”They are amazing and thorough with everything. I am surprised with how involved the management are, they are very good.” Care staff told us communication was good in the service. Systems were in place to audit and quality assure the care provided. People were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care, forums, and they were asked to complete a six monthly satisfaction questionnaire to help identify any areas for improvement. There was evidence as to how any feedback was acted upon and improvements made to the service provided.

We saw that the service had systems in place to support the recruitment of appropriate workers and we viewed recruitment processes that ensured relevant checks were carried out prior to recruitment. We viewed the personnel files of four care workers and saw that appropriate induction and training plans were in place. Staff we spoke with told us they were happy with their work. One staff member told us "I really enjoy working for Martlets Care. They are friendly and supportive and respond to any concerns very quickly." Another staff member told us "Most of the time it's pretty good. A nice company, very professional."

We observed care being delivered by workers who understood the care needs of people requiring support in their own homes. We visited two people who use the service in their homes and we spoke with a further person by telephone. We spoke with two relatives and six care staff, including a care supervisor.

People were very complimentary about how staff cared for them and the services provided when staff came into their homes. They told us that staff treated them with dignity and respect when undertaking some very personal care.

We reviewed a variety of mechanisms that the provider used to monitor feedback from people and among the letters and cards received we found the following comments. 'They are just wonderful ' every single member of the team who visited was caring, compassionate and highly professional.' 'I cannot comment highly enough about the home team'.

Several people told us that they had received services from other organisations prior to engaging the services of Martlets Care. They commented that Martlets Care 'was getting it right' and 'finally ticking all the boxes for them in providing good care'.