In Caring Hands

Updated 1 January 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

One inspector

Service and service type

This service is a domiciliary care agency. It provides personal care and support to people living in their own homes.

Notice of inspection

We gave the service two days’ notice of the inspection visit in accordance with our current methodology for the inspection of this type of service. The service was able to seek people’s consent to talk with us by telephone. Inspection activity started on 16 December 2019 and ended on the 19 December 2019. We visited the office location on 19 December 2019.

What we did before inspection

We reviewed information we had received about the service since the last 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 used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and six relatives by phone about their experience of the care provided. We visited two people in their own homes and received feedback from one healthcare professional who worked with the service. We spoke with two care staff, two registered managers and the provider.

We reviewed a range of records. This included four people’s care records. We looked at two staff files in relation to recruitment and a variety of records relating to the management of the service.

After the inspection

We spoke with a further three members of care staff and received feedback on the service’s performance from a health care professional. We reviewed the staff training and support records and staff meeting minutes.

Updated 1 January 2020

About the service

This service is a domiciliary care agency. It provides personal care and support to people living in their own homes in the community in The St Austell and Roseland areas. The packages of care provided range from providing support to help people get up and go to bed, meal preparation and help with housework, to going out in to the local area and attending medical appointments. At the time of the inspection the service was supporting a 31 people.

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

People using the service consistently told us they felt safe and that staff were caring and respectful. Their comments included, “The staff are wonderful, and [Relatives name] is very safe with them all” and “I feel totally relaxed and safe with the staff.”

There were enough staff available to provide all planned care visits. The service had experienced considerable recruitment challenges recently with staff leaving quickly after commencing their employment. The provider told us they were reviewing their processes to try to avoid this. All necessary recruitments checks had been completed for new staff.

Only one of the people we spoke with reported having experienced a missed care visit. This was due to the hospital not informing the service about the person’s discharge in a timely manner. This person had family to support them and did not suffer any impact because of this missed visit. The provider closely monitored for any missed visits.

Risks had been identified and assessed and staff were provided with guidance on how to manage and mitigate risks while providing support. However, we identified that one recent risk assessment review had failed to identify considerable trip hazards in one person’s home. We discussed this with the provider and were assured this would be reviewed immediately with the staff concerned.

An electronic call monitoring system was in place to record visits when they were provided. This enabled the provider to check they were at the time agreed. However, due to fluctuating internet signal around specific areas of the county this had proved unhelpful in monitoring staff visits to some people. The provider audited daily care records to ensure people had the agree length of time spent with them.

The service had appropriate procedures in place during periods of adverse weather.

The service had vehicles available to staff when needed, to reduce the risk of visits being missed due to vehicle breakdowns.

People were supported to take their medicines as prescribed.

People and relatives told us, "Absolutely marvellous, we really are so blessed to be receiving support from In Caring Hands they are a lovely agency. They are flexible and extremely helpful. We work well together” and “I would recommend them and give them 110%.”

People received support from small teams of staff who visited regularly. Staff told us, “I tend to visit the same people most of the time. You really get to know them well” and “They [Management] try to keep us on the same round.” Relatives told us, “We have our regulars, they are all wonderful”

People were able to make choices and staff respected their decisions. Some people requested only female staff, and this was respected.

People and their relatives were involved in the development and review of care plans. A recent survey’s responses showed people, or their relatives, were aware of the care plan and involved in any changes that may be needed.

Care plans included clear guidance on the support required during each visit.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Some people were accompanied by staff to attend medical appointments.

Staff were well motivated and there was a positive open culture within the service. The provider and management were very keen to provide the best service possible.

People’s feedback was valued, and records showed action had been taken to address and resolve any issues reported to managers.

Management roles were clearly defined and there were effective quality assurance processes in place. People and relatives told us the service was well led. Comments included, “The manager is a very good organiser, we have no concerns at all. I would give her an A star” and “Mum really gets on well with the staff, knows all their names and gives them all a hug when they leave, and that is the most important thing for me. They always let me know if things change.”

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 good (published 10 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.