Archived: Boldglen Limited (Sheppey)

During this inspection, the inspectors focused on answering our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people who used the service were protected from the risk of abuse because the provider ensured that employees were of good character and suitable to work with vulnerable people. All staff had been subject to Disclosure and Barring Services (DBS) checks before they started work. The manager also requested references and other documentation ensuring they were of good character and that they were entitled to work in the UK.

All care staff had received training in the safeguarding of vulnerable adults and in the principles of the Mental Capacity Act 2005. One member of staff told us, 'We are aware of the whistle blowing policy and would not hesitate to report anything that is not right'.

We found risk assessments with clear action plans were in place to ensure people remained safe. People's consent to care and treatment was sought appropriately. Staff monitored people's health and referred to health professionals or alerted emergency services when necessary.

Is the service effective?

The delivery of care and treatment was in line with the assessments of needs and care plans for people who used the service.

People and their relatives who were contacted told us they were very satisfied with the quality of care that had been delivered. We looked at nine people's assessment of needs and support plans, and we checked with people who used the service that the delivery of care was in line with their care plans and assessed needs. We found that people's needs were re-assessed bi annually, or when needed, and that their care plans were adjusted to reflect changes in needs. People who used the service commented, 'We're quite happy with them. As things have changed so has what the carers do for me', and another said of their carer 'She will also check that I'm ok and do anything else if the time allows and for example helps me make a cup of tea before she goes. She does not usually do meals but does help me in the evening if I want to use a ready-meal as I struggle to cook myself'. '. A relative said, 'I am always invited to my mother's care planning meeting and we are able to contribute and our opinions are dealt with positively'.

We found that the staff had received the training they required to meet the different and individual needs of people who used the service. Additional training was available for staff to give them the knowledge they needed to care for people with specific conditions such as dementia, and stroke.

There was an ongoing robust recruitment process that followed legal requirements to ensure the service had a sufficient number of trained and experienced staff.

Is the service caring?

We found that people who used the service were supported by kind and attentive staff. All the people who used the service that we spoke with were complimentary about the care workers' approach and attitude. One person who used the service told us 'They make sure I'm safe when they are helping me and they make sure it's done with dignity, and they then make notes in the book'. A relative told us, 'My wife has had no falls or injury with them, but they still try to let her be as independent as possible, by letting her do anything that she can for herself whilst washing or dressing. X prefers just women staff and they have always just sent women'.

One staff member told us, 'We treat the people who use the service like how we would like to be treated ourselves'. Another staff member said, 'Helping people is a privilege'. One staff member described how they respected people's dignity and privacy and how they promoted people's independence. For example, during personal care, curtains were drawn or doors were closed and people were encouraged to do as much for themselves as they were able to. People's comments about the service included: 'The pain of my condition wears me out, so the help at tea time helps me to cook hot food and I need them to carry and pick things up, and 'It's good that they get to know how I want help because sometimes I do it myself, but sometime I need the help'.

Is the service responsive?

The service responded to people's needs. For example, a member of staff told us, 'I have told the office how one person whom I visited was struggling and needed more time and the manager made sure their care package was increased'.

The service made sure there was additional training such as caring for people who needed to be fed with a gastric tube, or who had dementia, diabetes, had experienced a stroke, or approached end of life was available.

The manager explained they sought the views of people's who used the service and followed up their comments and suggestions with remedial action.

Is the service well-led?

We found that the registered manager had a system of quality assurance in place to identify how to improve the service. People and their relatives or representatives were regularly consulted about their level of satisfaction and survey questionnaires were provided, collected and analysed.

We saw the service operated an 'open door' policy where staff were encouraged to express their views. All the members of staff we spoke with confirmed they felt supported by the manager to carry out their roles and were able to discuss any concerns. A member of staff said, 'Our views matter and we are listened to'.

Staff meetings were held and recorded and all staff had formal one to one supervision so staff were able to also express their views. They also provided a forum to make sure there was good communication between the management and care staff. Staff's practice was regularly observed and monitored to check good care practice was maintained and to identify whether additional training or refresher courses were needed.

Care and support plans were detailed and highlighted any possible risks which through effective management could be minimised. People told us that the agency went through the plans with them at least twice a year to make sure they were happy with the support provided.

People told us that the staff were reliable, normally turning up at the expected time, and staying for the full length of the call. People commented; 'The staff are so kind and I look forward to the visit',' I am never rushed and get the chance to do what I can for my self.'

The staff had had effective training to ensure that they understand nutrition for the elderly and food safety.

Safeguarding and whistle blowing training was undertaken by staff during their initial induction and refreshed in a timely way to make sure people in there care were kept safe from abuse.

The agency had an effective complaints procedure, the information from which had been used to improve the service they provided.

People's responses included the following comments: 'the care staff are very friendly,' "I was very pleased with the help that I was given,", "all the staff I see are very good, they all know what they are doing but always ask me first what I want." and "I found all the staff to be very kind and caring. Nothing was too much trouble."

On the surveys we read; 'The reliability and devotion to duty is exceptional.' Another said 'I am more than satisfied with the care, they treat me with respect, the staff always look smart and tidy.' Staff are all very pleasant, very caring and friendly.'

We did find that staff had not received training regarding nutrition and special diets. Staff spoken with were not confident about preparing meals for people with diabetes for example although the agency did support people with this condition.