All Seasons Care Limited

All Seasons Care is a domiciliary care service, providing the regulated activity of personal care. The service provides support to older adults, people with physical disabilities and people living with dementia. At the time of our inspection there were 22 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

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.

At the time of the inspection, the location did not care or support 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.

Right Support

People told us they felt safely supported by the service and were happy with their care. Systems were in place to protect people from harm and people’s risks were assessed in a person centred way. People were supported by safely recruited staff who knew their care needs well.

Right Care

Staff understood how to protect people from poor care and abuse. The provider worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture

The quality of people’s care was regularly assessed. We found some areas which required improvement. These were in relation to guidance for staff around some people’s specific health needs and how prescribed creams should be used. People were happy with how easy it was to get in touch with the management team. They told us they were contacted regularly to make sure they were happy with their care.

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 07 November 2017).

Why we inspected

We inspected this service due to the length of time since the previous inspection. We completed a focused inspection of the key questions safe and well led. 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 remained 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 All Seasons Care Limited 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.

This service provides care to people living in their own homes and there were 30 people receiving personal care when we inspected. At the last inspection, in July 2015, the service was rated Good overall. At this inspection we found that the service remained good overall.

There was a registered manager in post. 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.

People’s care was delivered in a safe way when they received care. Care staff protected people from the risk of potential abuse and understood the potential signs to report. People’s safety had been assessed and reviewed and their individual risks recorded. The plans showed care staff the steps needed to reduce a person's risks and prevent risk of harm or injury. People who had support with their medicines had them administered when needed, with staff that were trained and competent to do so.

The provider offered training linked to people’s needs and care staff were knowledgeable about their roles and responsibilities. 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 told us they arranged their own healthcare appointments and that care staff were helpful in providing reminders of appointments.

People received care in their home from care staff they knew and liked. People received care that supported their independence and were able to direct staff on each call. People’s dignity had been supported and staff were respectful of people’s human rights.

People were involved in planning and changing their care which had been recorded in their care plans. The management team had been regularly reviewing these alongside people’s requests and people’s plans were updated when needed. People knew how to contact the office and were confident in how to make a complaint should they wish to.

People were contacted regularly from the management team to ask about their views and feedback on their care. Care staff spoke with the manager and provided feedback on the service. The manager told us they kept their knowledge current and provided staff with input and direction about the levels of care they expected through regular meetings and supervisions. The management team monitored the quality of the care that people received, this included reviewing records and observing staff practices.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

During this inspection we looked at the staff recruitment records for six members of staff. Appropriate checks had been undertaken before staff began work.

We spoke to people who used the service who confirmed they felt safe and were not afraid of any of the staff who came to support them. Comments from people included," If there is a problem the worker calls the office, they call me, I give advice. I have no concerns at all about my relatives safety" and "They are friendly and reliable. I feel completely safe with my carer."

We checked people's care plans and found that these were detailed and up to date. Risks related to people's homes or their specific care needs had been identified and recorded to ensure that people had their care provided safely and risks to them and / or other people were minimised.

There were policies and procedures in relation to safeguarding and the Mental Capacity Act. Staff had received or were booked onto training to update their knowledge about these areas.

Is the service effective?

People told us they were happy with their care and support. People's comments included, 'It is all very good', "I have no problem with them at all-excellent" and "They do what they are meant to do, when they are meant to do it. They knock the socks off other agencies we have used."

The records we looked at and the conversations we had with people using the service and their relatives indicated that people received plenty of time to undertake their personal care to a high standard.

Records showed that regular meetings were held with people or their relatives if appropriate, to review their care needs.On relative told us," They ask us regularly if we are happy with the care and if it meets our needs. If we suggest anything it is sorted straight away."

Is the service caring?

Staff we met spoke with compassion about the people they were supporting. People told us that staff were "Lovely", "Kind and lovely" and "The carers are excellent, they are clean, tidy and very caring and they are considerate, respectful and really interested in my mom's health and care.'

Some people had support from the agency to promote their independence and community involvement. One person told us that staff had supported their relative to a hospital appointment. They had been pleased with the level of information that had been fed back to them.

Is the service responsive?

People told us they were regularly asked if they were happy with the service and were given the opportunity to make a complaint if they were unhappy. People told us they were able to raise any concerns they had. One person told us, 'They often ask how the service is going. There is rarely anything negative to say but even small problems are quickly nipped in the bud." '

Where people who used the service were able, they were asked to comment on the service provided, this included questions about the support they received. This feedback was used to develop the service or provide assurance that people were receiving safe and effective care that met their needs.

During our visit we looked at records of complaints and incidents. We found that consideration had been given to these by the registered manager and actions had been taken to reduce the likelihood of similar incidents happening in future.

Is the service well-led?

Feedback about the management and leadership of the service was overwhelmingly positive. Comments included,"The office staff are brilliant." Staff told us they felt supported by the management team and had access to advice and support when they needed it.

We found that the agency was generally operating in a very effective and well organised way. However we found that records did not always show people had received their prescribed medicines or had enough to eat for example. There was no system in place to identify these shortfalls and either provide reassurance or take remedial actions. The provider understood these comments and gave immediate feedback about what they would do to improve upon this.

We found that systems to ensure all staff received regular documented supervisions, spot checks of their practice and team meetings had been developed. These provided staff with an opportunity to speak with a member of the management team in confidence and for the agency to assure themselves that staff remained adequately trained and supported to undertake their role. This was a way of ensuring that people using the service were being cared for by staff with the training and support they needed to undertake their role.

We found that people had been involved in the planning of their care, and people went on to tell us how most staff asked them at each visit what they needed, and how they wished to be supported. We found that care was delivered in a way that was unique to each person, and took into account their specific needs.

We found that each person had a plan of care, and people we spoke with told us they were happy with the way care was given. Comments included," They are very thoughtful" and "It's just great. I can't say enough good about them."

We found that systems were in place to ensure that abusive practices would not be used or tolerated. Staff we spoke with had a good understanding of adult safeguarding, and what action to take in the event of abuse being reported or suspected.

We found that staff had been provided with the training they needed to undertake their role well. People told us all staff were of a high standard. We found that the agency was not carrying out suitable checks on staff performance or supporting them appropriately.

We found there were systems in place to check on the quality of the service provided.