Archived: Carol Spinks Homecare

Updated 15 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This focussed inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 as stated in the warning notices relating to Regulation 12 Safe care and treatment and Regulation 17 Good governance.

One adult social care inspector undertook this focused inspection of Carol Spinks Homecare on 6 July 2017. We gave the provider 48 hours notice so we could be sure a manager was available to assist us. We inspected the service against two of the five questions we ask about services: is the service safe? And is the service well led?

Before our inspection we reviewed the information we held about the service, including notifications received and information from the local authority.

We spoke with the providers, one being the registered manager, the support manager and two care workers in person. We visited one person with their permission in their own home and met their relative. We spoke to one relative in person and an expert by experience spoke to 15 people on the telephone and a further two relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. We looked at four people’s care records and risk assessments and records relating to the management of the service such as staffing rotas, training, incident reports and audits.

Updated 15 August 2017

We carried out an announced comprehensive inspection of this service in January 2017. During that inspection we found the service was failing to comply with Regulation 12 Safe care and treatment and Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In relation to Regulation 12 Safe care and treatment, we found people’s risk assessments did not identify and ensure risks were minimised. Staff administering medication and assisting people with their mobility had not always been trained to do so. Not all staff had been recruited robustly before commencing employment and some people did not receive visits at times they needed them. In relation to Regulation 17 Good governance we identified that some systems or processes in place to assess, monitor and improve the quality and safety of the service were not always effective. For example, recognising the above issues and ensuring actions were taken. Staff call times were not audited to ensure staff visited at the required times and care records were not audited. Following this inspection in January 2017 we issued two warning notices relating to Regulation 12 and 17 requiring the service to become compliant with the relevant requirements by 21 April 2017. We received a satisfactory action plan from the provider detailing the actions they had taken to meet the regulations.

We then carried out this focussed inspection on 6 July 2017 to check Regulations 12 and 17 had been met. The evidence in this report only relates to the compliance of the warning notice and not the remaining key lines of enquiry for safe. We are unable to change the rating on this key question until the next comprehensive inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Carol Spinks Homecare on our website at www.cqc.org.uk. We found that all areas referred to in the warning notices had been addressed and Regulations 12 and 17 had been met.

Carol Spinks Homecare is a domiciliary care service that provides care and support to adults of all ages in their own homes. The service provides help with people’s personal care needs in Saltash, Liskeard and Callington and the surrounding areas. At the time of this inspection 80 people were receiving support with their care needs.

The service had a registered manager in post who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 2008 and associated Regulations about how the service is run.

All the people and relatives we spoke with told us they were very happy with the service. They felt safe and were very complimentary about their care workers and expressed confidence in the way the service was managed. Three people who had been out when we telephoned, phoned back because they wanted to record their appreciation. One person said, “I really hope they do well in the inspection. They certainly deserve top marks as far as I’m concerned!” Other people commented, “They [staff] chat away to him when they shower him – and it takes his mind off it. I’ve been amazed at how well he has accepted having carers in. He was dead set against it at first but he recognises that they have made life so much better for both of us”, “‘They [staff] are like gold-dust. They are all so good – I do have my favourites though. They are so well trained, so consistent” and “They [staff] treat me wonderfully. I was apprehensive at first of course. But they are so discreet, so understanding. They don’t get embarrassed, so I don’t get embarrassed.”

Staff rotas showed that there were enough staff to meet people’s needs. No-one had experienced a missed visit in the last 12 months and visits were monitored to ensure people received visits on time. People said they were always supported by staff they had been introduced to. Everyone said they felt the care workers were totally reliable. Everyone said they felt their care workers knew them/their relative well and they completely trusted the carers. People said they felt completely safe with the care workers and there were many compliments on their professionalism. People felt the care workers had the skills to do their jobs properly. The friendliness, compassion and kindness of the care workers were also frequently mentioned, and everyone felt they and their relatives were treated as individuals.

People’s care records had all been reviewed since the last inspection and held comprehensive information about how people wished to be supported. Records were regularly updated to reflect people’s needs. Risk assessments had been developed with the local safeguarding team and reflected people’s risks with clear information for staff about how to ensure these were identified and minimised.

The service training matrix showed all staff had received relevant and sufficient training to enable them to carry out their role effectively. A specialist external trainer in medicines administration and management in the community had ensured all staff who administered medication had received training. An updated medication policy was in place. Staff had received training in manual handling and there was an updated lifting and handling policy.

Recruitment records were robust and ensured that staff had received the relevant checks before commencing employment to ensure that people were safe.

There were effective systems in place to monitor the quality and safety of the service and drive on-going improvement in relation to the warning notices as the service had reviewed these. Where people raised concerns these were taken seriously and acted upon in a timely way.