CareRight

Updated 11 November 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 26 September 2022 and ended on 13 October 2022. We visited the location’s office on 27 September 2022.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed the information held on our system. We used all this information to plan our inspection.

During the inspection

We spoke with seven members of staff, including the provider and registered manager, five people who used the service and eight people’s relatives. We received feedback from two health professionals. We looked at four people’s care records, three staff recruitment files and we reviewed a range of records including the training matrix, supervision and appraisals, complaints and records relating to governance and oversight.

Updated 11 November 2022

About the service

Angel Home Care is a domiciliary care service providing personal care. The service provides support to people in their own homes within Bovey Tracey and the surrounding areas. At the time of our inspection there were 46 people using the service. People had a wide range of needs from minimal social support to assistance with all aspects of daily living. Some people were living with dementia and the service also supported people at the end of their life.

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

The provider and registered manager nurtured a culture which truly put people, and the local community, at its centre. Staff were unanimously positive about the provider, registered manager, office staff and each other. All of the people and relatives we spoke to were positive about the support they received. The provider organised celebrations and events to reduce people’s social isolation. For example, for the Queens Platinum Jubilee they hired a local hall and held a celebration for the people they support. This bought people who were often isolated together. The provider has strong links with the local community and organised regular charity events. During the heatwave, the provider opened the office space up for people to shelter and provided water. This winter they are offering the office as a ‘warm space’, for anybody in the local community to use, providing hot drinks and board games. The provider offered dementia training to local businesses, in order to support Bovey Tracey to become a ‘dementia friendly’ town. The office window display was regularly changed to engage, educate and support staff and the local community. For example, displays were produced to support mental health week, to feature information on dementia and about how to keep safe during the heatwave.

The provider worked in partnership with other healthcare professionals to ensure people got the support then needed and was committed to continuously improving the service. The provider and registered manager demonstrated an ability to maintain an excellent standard of care provision against a backdrop of the Covid-19 pandemic and some of the most challenging operating conditions the care sector has experienced.

People and their relatives told us care staff were exceptional and went above and beyond to support people. For example, one person told us, “It very much feels as if they care about me and I matter to them, and the job they do really matters to me. It’s nice to have care from people who are invested in it. They do go the extra mile.” Staff provided care in an exceptionally person-centred way. For example, one person’s family member was impressed that staff took pictures of the sunrise and of their changing garden to show their relative. Last Christmas staff provided 15 people, who had no family nearby and were unable to cook themselves, with a cooked Christmas lunch. This meant they had a traditional, hot meal and a visitor on Christmas Day. Staff were pro-active in looking for ways to maximise people’s independence and spoke about people with kindness, dignity and respect. A healthcare professional told us the person they were supporting hadn’t been out of their home, other than to medical appointments, for several years. Staff had arranged a wheelchair for them and taken them out for a ride in their car. They said, “[Care staff] know her really well, they are caring, warm and respectful.”

People’s care plans contained specific information about who they were as people, and how staff could understand and respect that. For example, one person’s care plan explained the colloquial Devonian terms they used to refer to people and told staff how important it was to them to have a laugh. People and their relatives were involved in creating and reviewing their care plans and told us how supportive staff were. Feedback from people and their relatives was sought. Comments made in response to a survey included, ‘I would like to put on record just how helpful and terrific [staff name] is and how life-enhancing this is for me.’ And, ‘You couldn’t do any better.’ ‘I feel very lucky to get the excellent care and kindness received from Angels.’ 100% of people who completed the survey said they would recommend Angel Home Care to others.

Systems were in place to safeguard people from abuse and people’s risks were assessed and well monitored. People were supported to receive their medicines safely. People’s care plans contained good detail about how staff could support them to manage their health conditions and the risks associated with them. Systems were in place to ensure staff were recruited safely. Disclosure and Barring Service checks were obtained. There were enough staff to ensure people’s needs were met and people told us staff had enough time to provide the care they needed, and to spend time talking with them. One person said, “If they’re rushed, they don’t show it.” Well established systems and processes to monitor quality were in place and systems were in place to record, review and learn from things that went wrong.

People’s needs were assessed prior to a care package being agreed and consideration given to which staff would be able to meet the individual person’s needs. Staff completed training relevant to their role and received regular spot checks, supervision and appraisal. People told us staff who cared for them were well trained and knew how to support them with their medical equipment. People were supported to eat and drink enough and staff monitored how much people were eating and drinking where required. One person’s relative told us, “They monitor her eating and drinking, they are very good at facilitating it.” People’s capacity was assessed where necessary and people were supported in the least restrictive way.

People had personalised care plans which they had developed with staff. Care plans contained detailed information about people’s preferences and how they wished to be assisted. People had been supported to created detailed end of life care plans, where they wished to do so. People’s care plans contained information about how they, and in some cases the people they lived with, communicated. Staff took action to reduce people’s social isolation. For example, by organising equipment so they could be more independent. Systems were in place to ensure complaint and concerns were reviewed to identify where care could be improved.

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.

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

Rating at last inspection

This service was registered with us on 4 December 2020 and this is the first inspection.

The last rating for the service at the previous premises was good, published on 13 November 2019.

Why we inspected

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

Follow up

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