We carried out a review of the data available to us about Care Staff Services Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Care Staff Services Ltd, you can give feedback on this service.
Care Staff Services Ltd is registered to provide personal care to people living in their own homes. At the time of the inspection 36 people were being supported with personal care. The main office is based in Burnham.
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 and relatives felt safe from harm and were aware of what to do if they felt unsafe. Staff were aware of their responsibilities to protect people from harm and had attended the relevant training. Assessments of people’s care and support needs identified risks to people’s welfare and safety and plans were put in place to manage those risks. There were enough staff to provide care and support to people. Medicines were administered safely, and staff followed infection control practices to protect people from infection. Staff recruitment practices in place ensured people were cared for by staff who were aware of good practice and references were sought. However, job applications were not always fully completed and gaps in employment were not always explained. We have made a recommendation about this in the report.
People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. People and relatives said consent was sought before care was delivered. The service acted in accordance with the Mental Capacity Act 2005 where people were not able to make specific decisions.
People and relatives spoke positively about the caring nature of staff. A person when commenting about their care worker said, "She is very helpful, calm, friendly, helpful and will go out of the way to help.” A relative when commenting about a care worker said, “She is very friendly and kind, helpful and very good to [name of relative]. She is so caring.” Staff had a good understanding of people’s care needs, family histories and care records showed staff were instructed to deliver care in a person-centred way.
People and relatives felt staff were skilled and experienced to look after them. Staff received appropriate induction, training and supervision. People’s nutrition and hydration needs were met. The service worked with health and social care professionals to ensure people’s health needs were met.
People and relatives said the service assessed their needs before their packages of care started. This ensured the service developed plans of care that was based on what people said they wanted. People and relatives said they were involved in decisions about their care and meetings to review and discuss any changes in their care happened. The service was compliant with the Accessible Information Standard by making sure the communication needs for people with disabilities and sensory impairment were met. People knew how to raise concerns and felt confident to do this. We found complaints were responded to appropriately.
People and relatives felt the service was well-led, staff spoke positively about the culture of the service and said management were approachable. Quality assurance systems in place was improved to enable the service to identify where quality and safety were being compromised. Appropriate action was taken to address any concerns identified however, further work was required to clearly identify themes, trends and lessons learnt. We have made a recommendation about this in the report.
Rating at last inspection and update: The last rating for this service was requires improvement (published 4 May 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The service has a registered manager. 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 and associated Regulations about how the service is run.
This is the first inspection under Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People and their relatives felt staff were caring, kind and listened to what they had to say. A person commented, “All carers are very friendly. They talk with me and we have a joke.”
People received care from staff that made them and those close to them, feel like they mattered. Staff had established good working relationships with people and their families’. Staff encouraged people to be independent and care records contained information about their personal circumstances and how they wished to be supported. People and their relatives said staff treated them with respect and protected their dignity.
People felt safe when receiving care and support from staff. Safe recruitment practices were in place and people were kept safe from infection. There were safe administration of medicines. We have made a recommendation for the service ensure their medicine policy is updated to reflect NICE (National for Institute for Health and Care Excellence) medicine guidance. Staff were aware of their responsibilities to protect people from abuse and had attended the relevant training. However; staff did not have access to the service’s safeguarding adult’s policy and the local authority’s specific procedures for reporting and managing safeguarding matters. We have made a recommendation for the service to ensure these policies are easily accessible to staff.
This meant the service did not have appropriate records to assess identified risks and the impact it had on people using the service.
People were supported to have maximum choice and control of their lives. However, we found senior staff had limited understanding of the MCA and its code of practice.
Staff were not always appropriately inducted; trained and supervised. We found staff did not always receive training; learning and development to enable them to fulfil the requirements of their role. Staff worked within the principles of the Equality Act 2010 to make sure their work practice did not discriminate against people. Peoples’ nutritional needs were met and they had access to other health services.
People and their relative felt the care delivered was responsive and met their specific needs. A relative commented, “I explained what we wanted and they (staff) have followed this.”
People had their needs assessed before and shortly after they joined the service. Care records were person-centred and recorded peoples’ needs and preferences. This did not include their preferences for end of life care. We recommend the service seek current guidance and best practice in relation to people’s end of life preferences and wishes and staff training.
People knew how to raise concerns. We found the service responded to complaints appropriately. The service was not aware of the accessible information standard and their legal responsibility to meet it. We have made a recommendation for the service to seek current guidance and best practice in order to be compliant with the Accessible Information Standard.
People and their relatives felt the service was well-led and staff spoke positively about the support they received from management. People were given the opportunity to express their opinions about different aspects of the service.
Systems and processes in place were not able to help the service identify where quality and safety was being compromised. The service’s statement of purpose (SOP) was not kept under review and, where appropriate, revised. We have made a recommendation for the service to take appropriate action to ensure its SOP is kept up to date.
We found breaches of regulations as a result of this inspection. You can see what action we told the provider to take at the back of the full version of the report.