Holywell Care Services (Morecambe)

Updated 17 February 2018

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.

Holywell Care Services is a domiciliary care agency. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Before our inspection, we checked the information we held about Holywell Care Services. This included notifications the registered provider sent us about incidents that affect the health, safety and welfare of people who received support. We also contacted other health and social care organisations such as the commissioning department at the local authority and Healthwatch Lancashire. Healthwatch Lancashire is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced when they received support from Holywell Care Services.

In addition we looked at the Provider Information Return (PIR) the registered provider had sent us. This is information we require registered providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

This inspection took place on 10 January 2018. We visited the office location to see the registered manager and office staff; and to review care records and policies and procedures. We telephoned people who received support, their relatives and staff to gain their views on the service provided.

One adult social care inspector and three experts by experience carried out the inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts by experience had experience of caring for older people, people living with dementia, people living with a physical or sensory impairment and people who received support within a community setting.

During the inspection, we visited one person in their own home to gather their views and to see what paperwork was held at their home to guide staff. We spoke with a further ten people who used the service and five relatives. We spoke with the registered manager, two members of the management team, ten members of staff and a health professional. We looked at the care records of five people and training and recruitment records of five staff members.

We looked at what quality audit tools and data management systems the registered provider had in place. We did this to ensure they had oversight of the service so that improvements could be made when necessary. We reviewed past and present staff rotas, focusing on how staff provided care within a geographical area. We looked at how many visits a staff member had completed per day and if the registered provider ensured staff had enough time to travel between visits. We looked at the continuity of support people received.

Updated 17 February 2018

This inspection visit took place on 10 January 2018 and was announced. The registered provider was given 48 hours’ notice as we needed to be sure people in the office and people the service supported would be available to speak to us. Holywell care services is a domiciliary care agency. It provides personal care to 24 people living in their own houses and flats in the community. It provides a service to older adults and people with a learning disability.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. “Registering the Right Support CQC policy.

There was a registered manager in place. 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 2008 and associated Regulations about how the service is run.

At the last inspection in October 2015, the service was rated ‘Good’. At this inspection, we found the service met the required fundamental standards and remained ‘Good’.

During this inspection, we found staff had received training to safeguard people from abuse. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of adults who may be vulnerable. Staff we spoke with told us they were aware of the safeguarding procedure.

Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

There was an appropriate skill mix of staff to ensure the needs of people who used the service were met. New staff worked alongside experienced staff members whilst they learnt their role. One staff member told us, “I had two days training it was in Preston it did help. I have just completed my care certificate they [registered provider] signed me up to NVQ3. They are on top of everything.”

The registered provider planned visits to allow carers enough time to reach people and complete all tasks required. People told us staff respected their privacy and dignity during their visits.

Care plans were organised and had identified the care and support people required. We found they were personalised and informative about the care people received. They had been kept under review and updated when necessary. They reflected any risks and people’s changing needs.

Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. The registered provider completed spot checks on staff to observe their work practices were appropriate and people were safe.

Staff were provided with personal protective equipment to protect people and themselves from the spread of infection.

The registered provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with people who may be vulnerable. Required checks had been completed before any staff started work at the service. This was confirmed during discussions with staff.

The registered provider had regularly completed a range of audits to maintain people’s safety and welfare.

Staff told us they received regular formal and informal support from the management team.

People and their representatives told us they were involved in their care and had discussed and consented to their care packages. We found staff had an understanding of the Mental Capacity Act 2005 (MCA).

When appropriate, meals and drinks were prepared for people. This ensured people received adequate nutrition and hydration.

Care records contained information about the individual’s ongoing care and rehabilitation requirements. This showed us the registered provider worked with other health care services to meet people’s health needs.

People said they had a team of regular carers with whom they and had built up good relationships. For example, one person told us, “My regular carer is the most caring woman I’ve ever met. The others that come are also really good.”

Staff we spoke with understood the support needs of people they visited. They knew how individuals wanted their care to be delivered. One person told us, “Having the same carers’ means they know what I like and don’t like.”

A complaints procedure was available and people we spoke with said they knew how to complain. At the time of our inspection, the registered provider had received no formal complaints.

The registered manager had sought feedback from people receiving support and staff for input on how the service could continually improve.

The service demonstrated good management and leadership with clear lines of responsibility and accountability within the management team.

Further information is in the detailed findings below.