Companion Homecare

Companion Homecare provides personal care to people in their own homes. The service is based in Preston and also provides support to people living in the Morecambe area. 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 our inspection, 85 people were receiving personal care.

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

We have made a recommendation about recruitment processes, although people were supported by enough staff that were trained appropriately for the role. Improvements were required in the recruitment processes. People were supported to take their medicines safely and were protected from the risk of abuse. Staff were aware of infection control guidance and people were protected from the risk of incidents being repeated.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. We considered this guidance as there were people using the service who were autistic.

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.

People benefitted from a positive culture within the service and staff enjoyed their jobs. The registered manager assessed risks and took steps to minimise them. The registered manager communicated well with people, their relatives and staff and encouraged further learning and development of staff to improve the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 3 November 2022). 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.

At our last inspection we made a recommendation about submitting statutory notifications and recruitment. The provider had acted regarding notifications, however further actions were required around recruitment.

Why we inspected

The inspection was prompted in part due to concerns received about recruitment. A decision was made for us to inspect and examine those risks. Although we found no evidence of harm, the concerns were partly upheld and the provider agreed to take actions to mitigate, which we will review at the next inspection.

Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Companion Homecare on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Companion Homecare provides home care services enabling people to be cared for while living in their own homes. The service is managed from the registered office in Preston and services are provided to people living in the areas in and around Preston and Lancaster. At the time of this inspection 91 people were receiving regulated personal care and support from 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

Most risks relating to people's needs had been identified. However, records did not always provide a detailed plan for managing these risks. Written protocols for medicines required as and when needed were not always in place for staff to follow to ensure medicines are given correctly and safely. There was no consistent clarity seen in records as to whether people's medicines were prompted or administered by the staff.

Systems were in place to record accidents and incidents. However, these were not consistently monitored to identify any lessons learned, themes or trends. Safeguarding incidents were identified and shared with the local authority. However, not all incidents and allegations had been notified, as legally required, to us. We have made a recommendation about submitting statutory notifications.

There were enough staff to support the number of people using the service. However, we received negative feedback from people about the consistency of their visit times. Recruitment processes in place were not always robust and needed to include more details to ensure people employed were of fit character. We have made a recommendation about the quality of recruitment suitability checks.

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. Consent to care and treatment had been obtained and where people lacked capacity relevant others had been involved in supporting people's decision making.

Training records demonstrated appropriate and relevant training is provided. Referrals were made to other healthcare services when necessary. People told us they thought the care they received was good and spoke positively about the staff who supported them.

People told us staff treated them with respect and dignity and were kind and caring towards them. Care plans generally demonstrated a person-centred approach. However, not all the care plans we looked were always fully completed. Records showed complaints are processed and responded to. End of life care where relevant is done co-working with the community nurses.

Quality monitoring and auditing systems were not in place. Regular oversight of the safety and quality of the service was not being recorded. However, we did see that since the service hadstarted improvements had been made in with the development of some systems and processes. There was no recorded analysis or reviews to see where improvements of the service could be made.

Electronic care planning and rota systems are used. However, we did not see that all records were consistently completed in enough detail. People could access the electronic care planning and rota system remotely to view information about their care. The provider had recently appointed independent reviewing officers to review individual people’s needs and obtain their views of their experience in the service. People gave positive feedback about the manager and staff.

At the time of the inspection, the location did not provide personal care for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

This service was registered with us on 10 January 2020 and this is the first inspection.

Why we inspected

This inspection was partly prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to the safe management of medicines, risks associated with people’s needs and the oversight of the quality and safety of the service at this inspection.

The provider and registered manager responded immediately during and after the inspection to address the completion of records and improve details in order to mitigate any potential risks.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.