Care a la Carte

Updated 5 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 and 22 November 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to support the process.

The inspection was carried out by one adult social care inspector and an Expert by Experience, which is a person who has personal experience of using or caring for someone who uses this type of care service. Their involvement was limited to phoning relatives to ask them their views of the service.

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plans to make. We also spoke to the main commissioning body for the service.

We reviewed the care records for seven people using the service to see if they were up-to-date and reflective of the care which people received. We also looked at records for eight members of staff, including details of their recruitment, training and supervision. We reviewed further records relating to the administration and management of medicines, audits and complaints to see how the service was run.

During the inspection, we spoke with two people and 10 relatives. We also spoke with the registered manager, care manager, client liaison manager and four care staff. In addition, we wrote to 10 members of staff to obtain their written feedback. We received seven responses.

Updated 5 January 2019

This inspection took place on 5 and 22 November 2018 and was announced.

Care A La Carte is a domiciliary care service and provides the regulated activity of ‘personal care’ to people in their own home specifically specialising in providing care staff to people requiring live-in care and support. The service acts as a referral and support service where care staff are recruited, but are self-employed and are matched with people who require this level of support. At the time of this inspection the service was working with 34 people who were receiving care and support from care staff that the service had placed with them.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

People and their relatives told us they felt safe when receiving care and support from the care staff allocated by the service. Care staff demonstrated a good understanding of safeguarding and the steps they would take to protect people from possible abuse.

Risk assessments detailed people’s individual risks associated with their health and care needs and gave clear guidance on how to reduce or mitigate the risks in order to keep people safe.

The service followed appropriate medicines management and administration processes which ensured people received their medicines safely and as prescribed.

Recruitment of staff was a rolling process as the service needed to ensure they always had sufficient numbers of staff to meet people’s needs. Recruitment processes in place ensured that only those staff assessed as safe to work with vulnerable adults were recruited.

The service carried out an assessment of need for each person so that the service could determine whether they had the appropriate staff to be able to meet the person’s needs effectively.

Lessons were learnt from incidents and accidents to minimise a re-occurrence. Staff were supported and trained to undertake their roles.

People were appropriately supported with their nutrition and hydration needs to ensure they maintained a healthy and balanced diet. Where people had specialist dietary requirements these had been incorporated into their care plan and delivery.

People were routinely supported to access a variety of health and social care services or where there was an identified need or concern.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives confirmed that they were treated with dignity and respect and that care staff were kind and caring with whom they had developed positive relationships.

People were involved with the planning and delivery of their care and where appropriate relatives had also been involved in the process. Care plans were person centred and responsive to people’s needs.

People and their relatives knew how to make a complaint and were confident their concerns would be resolved.

People, relatives and staff commented positively about the registered manager and how the service was managed.

There was an open and transparent culture at the service. People received care that was focussed on meeting their individual needs.

Regular audits and checks were carried out on the quality of care people received.

Further information is in the detailed findings below.