3 September 2018
During a routine inspection
We visited the provider’s offices on 3 September and made telephone calls to staff, people using the service and their relatives on 4 and 5 September.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people, younger adults, people living with dementia, people who have mental health conditions and people who have disabilities.
There were two registered managers in place. 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.
Staff had a clear understanding how to keep people safe when they were delivering care and to support them to remain safe at other times. Risks assessments concerning people and their homes were completed and regularly updated. Staff could access these at the providers office or in care files retained in people’s homes.
Sufficient staff were deployed to meet people’s needs without needing to rush care delivery. Travelling time had been built into staff schedules and ensured that booked times were usually met.
The service had expanded since being set up however it had grown slowly as the registered managers recruited new staff prior to taking new clients to ensure they were always able to meet commitments.
Recruitment practices were safe however there were problems at times in obtaining references from other similar providers. The registered manager evidenced attempts to obtain work references and had sought character references when work references were not possible.
Staff received training and equipment in order to safely complete their work and had annual updates in training to ensure they remained aware of current best practice.
Safety checks were in place so that the on-call manager was informed when staff were safely home after an evening shift to safeguard their well-being.
An in-depth assessment was completed before people’s care packages commenced and people or their relatives were involved in care planning as fully as they were able.
Staff participated in supervision and appraisals and were supported to complete diploma level training to develop their careers. Regular spot checks were carried out by senior staff to ensure that care staff were providing appropriate care to people.
Food and nutrition were central to people’s care provision and whenever possible staff would prepare and cook fresh meals for people rather than reheating readymade meals.
Staff were trained to prepare meals for people who had safe swallow plans and when necessary received training from nutrition nurses so they could support people with PEG feeds.
The service was very caring, people told us they were very happy with the care they received.
Care plans were person centred and reflected the person’s preferences as to how to receive their care.
Once care tasks were completed, staff supported people with household tasks or sat with them for a chat. Staff did not need to rush off to the next call and enjoyed spending time with people.
Staff communicated with people in the most appropriate way for each person. Information on people communication needs was seen in care plans. Written information was presented to people in their requested format and staff would read peoples care bookings out to them.
The provider responded to emergencies well and had sent staff to additional calls when asked.
There was a complaints procedure however very few complaints had been received by the service.
The service supported people with palliative and end of life care and were committed to providing these types of care at a very high standard to ensure that people could have a good death.
The service was recently restructured and a new deputy manager now supported the two registered managers.
Quality assurance and training are focus areas for the service with each registered manager training in and developing these areas.
Staff morale was good and staff retention levels were high. Staff felt valued by the provider.