Carers Direct Homecare Ltd

Carers Direct Homecare Limited is a domiciliary care service. The service provides care and support to people living in their own homes. At the time of the inspection there were 152 people using the service.

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 their family members spoke highly of the service they received. They praised the management of the service and the effective communication, with both themselves and each other. They told us how they felt reassured and safe as staff followed government guidance on COVID-19. A family member told us, “I am confident that the company is well managed and efficient. They have handled COVID-19 and lockdown regulations really well. I would definitely recommend this service with confidence.”

People told us the service was very reliable and that they were supported by a core group of staff who they had developed positive and supportive relationships with. People spoke of the kind and caring approach of staff, and that staff were able to converse with them in their first language of Punjabi, English and Guajarati. A family member told us, “The standard of care is always the same, they don’t rush the care. I think the correct word is empathetic. They are proactive and they are consistent.”

Staff were aware of their responsibilities in safeguarding people and knew how and who to raise concerns with. People were supported by a core group of staff who had undergone a robust recruitment process. Staff upon their appointment underwent a period of induction and a programme of training which was regularly updated.

People’s safety was promoted by staff who followed guidance on how to reduce potential risk. People were supported with their medicine’s safely by staff who had had their competency assessed. The registered manager and staff adhered to government guidance in relation to COVID-19 to promote the safety and wellbeing of people and themselves.

The management team were aware of their role and responsibilities in meeting their legal obligations. Systems to monitor the quality of the service were in place and were used to develop the service and drive improvement. People’s views and that of their family members and staff were regularly sought.

Good communication between the registered manager, staff and external partner agencies enabled the service to support people well. The registered manager provided key information, such as surveys and information about COVID-19 in Asian languages.

The registered manager had worked with local Asian radio stations to share information both for the service, and the wider 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 Good (published 9 March 2020)

Why we inspected

We received concerns in relation to inconsistent infection prevention measures being adopted by staff. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carers Direct Homecare Ltd 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.

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 felt safe with staff from the service. Care plans and risk assessments provided guidance for staff to follow to reduce risk to people’s safety. Staff understood how to protect people from the risk of harm and understood potential signs of abuse.

People and relatives were involved in assessments of potential risks to safety and in identifying measures to keep them safe. Staff went through a recruitment process so the provider only employed suitable staff, though the system was not fully robust.

People and relatives said people received their prescribed medicines. There were a small number of records with gaps in dosages to be supplied. People were protected from the risk of infections through staff working practices. People had enough staff to meet their needs. Staff undertook induction training which provided them with the knowledge and skills to do their job well and effectively meet people’s needs.

People were provided with care and support that ensured they had good nutrition and hydration. They had access to healthcare which maintained their health and wellbeing. People were supported to have choice and control of their lives and staff supported them to do this.

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.

Staff knew people well. People had developed positive relationships with staff which helped to ensure good communication and support. Staff respected people’s privacy and dignity and encouraged people to be as independent as possible.

People or their representatives were involved and consulted when making changes to how their support was provided. Staff knew and understood the needs of the people using the service and care was provided based on their assessed needs. Staff were responsive to changes in people's needs to ensure people received timely help to maintain their health and well-being.

People and relatives knew how to raise any concerns or make a complaint. The provider had a policy and procedure which involved investigation and solutions to put things right. This provided information about how these would be managed and responded to.

Systems were in place to monitor the quality of care and support people experienced through quality assurance systems and processes to drive improvements in the service. However, the system needed to be more thorough.

People, relatives and staff spoke positively about the management and leadership of the service. People said staff were very friendly and caring, and they had good relationships with them.

The service worked in partnership with external agencies to ensure people achieved good outcomes from their care and support.

Rating at last inspection:

The last rating for this service was good. The inspection report for this inspection was published in July 2017.

Why we inspected:

This was a planned inspection based on the previous rating .

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

A registered manager was 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 and associated Regulations about how the service is run.

Risk assessments were in place to protect people from risks to their health and welfare, though these did not cover all assessed issues. Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff.

People and relatives we spoke with told us they thought the service ensured that people received safe personal care from staff. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

We saw that medicines had been supplied safely and on time, to protect people’s health needs.

Staff had received training to ensure they had skills and knowledge to meet people's needs, though more training was needed on some relevant issues.

Not all staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. Assessments of people's capacity to make decisions were not always detailed to determine whether they needed extra protections in place to keep them safe.

People and relatives we spoke with all told us that staff were friendly, kind, positive and caring. They told us they had been involved in making decisions about how and what personal care was needed to meet any identified needs.

Care plans were individual to the people using the service to ensure that their needs were met.

People and relatives told us they would tell staff or management if they had any concerns, and they were confident these would be properly followed up.

They were satisfied with how the service was run. Staff felt they had been fully supported in their work by the management of the service.

Policies properly set out information about the need to refer to the relevant safeguarding agency. The registered manager was aware that these incidents, if they occurred, needed to be reported to CQC, as legally required.

Management had carried out audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service, though more detail was needed to fully show what checks had been made.

People told us that they felt involved when decisions were made about the support they received. They also told us that staff were courteous and treated them with respect. One relative we spoke with told us, 'When the care plan was done we discussed all the requirements.'

People also confirmed that the service was delivered in a reliable way. They told us that staff usually arrived on time and stayed for the expected length of time.

Staff we spoke with understood the types of concerns that may present a risk to the vulnerable people they supported and they were alert to these. They also told us that they felt well supported and found the manager of the service to be approachable and available.

Satisfaction surveys had been sent to people who used the service and also to employees and demonstrated that levels of satisfaction were high.