Holywell Care Services (Morecambe)

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.

As part of this responsive follow up inspection we spoke with the senior care coordinator, training officer, care staff, clients and their carers. We also visited people who received a service in their own home. We did this to take account of the views of people who used the agency and staff who worked there.

Staff we spoke with told us things had changed for the better, in that people's needs had been reviewed and risk assessments put in place in the home of people who used the agency. Comments from staff included, 'I know the care plan and risk assessment was updated and in the homes of the clients I visit.'

We visited a person in their own home to see what changes had been made. We found care plan records in place but not reviewed. This could potentially put people at risk of not receiving appropriate up to date care and support. We spoke with the senior staff member responsible who said it was an oversight and since the previous inspection, care and risk assessment records had been updated.

We spoke with the commissioning authority who had been monitoring the service since September 2013. They had found improvements in the care and support the agency provided.

In the main people were also pleased about the quality of care delivered. However a relative we spoke with expressed some concerns that a particular member of staff did not always ask his mother want she wanted. We were told that this member of staff presumed what the client wanted.

People also told us that generally there was a good consistency of staff support, with the same care worker or small team of care workers visiting each day. It was clear that support staff had built up good relationships with the people they supported and that these relationships were valued. One relative said, 'My husband can speak good English but it is nice for him when the carers speak to him in his own language'.

Staff told us that a range of training was taking place, qualification training was available and that the manager was approachable and supportive. We were told that surveys had recently been distributed to capture the views of people using the service. People also told us that they were visited by senior staff giving opportunity to give feedback about the quality of the service. However we noted that record keeping in people's home's needed to be improved in order to keep people safe.

People who use the service told us the agency provided a good service. Comments included, 'We are really glad we have Hollywell the staff are tremendous.' Also, 'No complaints they are very reliable, competent and polite when they come and visit us.'

People told us they had received a visit from the owner of the agency before the service commenced. They told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for. One person said, 'The manager always keeps in touch to see everything is ok I like the personal touch the agency has.'

We found that there was enough skilled and experienced staff so that people had their care delivered at the right time, usually by the same people and in ways they wanted. One person said, "They do try and stick to the same carers which helps."

Suitable arrangements were in place to protect people from the risk of abuse. People told us they felt safe with the care staff and said they would report any concerns to a manager.