Oxford Private Care

Oxford Private Care is a domiciliary care agency. It provides personal care to people living in their own homes in Oxford and the surrounding areas. It also provides a live-in service for people with more complex needs. The service was providing personal care to 139 people.

People’s experience of using this service:

The provider demonstrated they had made significant improvements since our last inspection. We found the service had improved and met the characteristics of an Outstanding service in well-led domain and a Good service in safe, effective, caring and responsive.

The service was very well-led which resulted in provision of outstanding care. The service had a clear management and staffing structure in place. Office staff and care staff worked well as a team. Staff aimed to provide a high quality of service and they had a sense of pride working at the service.

The service had a track record of being an excellent role model for other services. The provider worked in partnership with other health and social care bodies to build seamless experiences for people based on good practice and people’s informed preferences. It was clear other providers recognised the contribution the provider made to the health sector in ensuring people received high quality care. The management team and staff strove for excellence through consultation, research and reflective practice. The provider was actively involved in several coproduction projects aimed at improving people’s quality of care.

The leadership, governance and culture drove high-quality, person-centre care. The provider had effective systems in place to monitor the quality and safety of the service that included the use of technology. Where the provider identified an area for improvement prompt action was taken to address it. Actions from the audits were used to further develop the service. The provider monitored service delivery on ongoing basis and effectively used feedback from people, relatives and staff to improve the systems, practices and people's experiences.

The provider had an excellent workplace culture for staff. Staff were highly valued by the provider and management team. Staff contributions were highly appreciated and celebrated. Staff told us they were proud to work at the service and called it a family business. Staff told us they felt part of the family and spoke very highly about the support they received and how they were encouraged to be fully involved in the development of the service.

We received positive feedback from all people and relatives. The feedback reflected staff were very kind, caring and committed. People complimented the continuity of care provided by regular staff which contributed to building of meaningful relationships. Staff exceeded in recognising what was important to people and ensured individually tailored approach that met people's personal needs, wishes and preferences was delivered. There was evidence the staff often went 'the extra mile' to meet people's needs.

People were supported by caring staff that knew them well and understood how to maximise their potential. People were supported to maintain relationships with their families and friends and the value of relationships was central to the success of the service. People's independence was promoted and they received support to achieve their goals and reduce social isolation.

Oxford Private Care ensured people received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely and people received their medicines as prescribed.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.

Rating at last inspection:

At our last inspection we rated the service good. Our last report was published on 8 November 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Oxford Private Care is a domiciliary care service providing care to people in their own homes in and around Oxford. At the time of the inspection the service was supporting 202 people.

There were two registered managers 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 2008 and associated Regulations about how the service is run.

Leadership within the service was open and transparent at all levels and promoted strong organisational values. This resulted in a caring culture that put people using the service at the centre. People, their relatives, staff and healthcare professionals were complimentary about the management team and how the service was run.

People who were supported by the service felt safe. The staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicines as prescribed. There were systems in place to manage safe administration and storage of medicines.

The service had some staff vacancies which were covered by regular suitably qualified and experienced staff to meet people's needs. The service experienced some late calls but always ensured all calls were completed. The management team were taking action to ensure safe staffing levels. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager) and team meetings to help them meet the needs of the people they cared for.

The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA.

People’s nutritional needs were met. People were given choices and were supported to have their meals when they needed them. Staff treated people with kindness, compassion and respect and promoted people’s independence and right to privacy. People received high quality care that was personalised to meet their needs.

People were supported to maintain their health and were referred for specialist advice as required. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible. The service provided double ups (two staff) and live in carers during end of life care.

Staff knew the people they cared for and what was important to them. Staff appreciated people’s unique life histories and understood how these could influence the way people wanted to be cared for. Staff supported and encouraged people to engage with a variety of social activities of their choice in the community.

The service looked for ways to continually improve the quality of the service. Feedback was sought from people and their relatives and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

The registered manager informed us of all notifiable incidents. The registered manager had a clear plan to develop and further improve the service. Staff spoke positively about the management support and leadership they received from the management team.

The provider sent us an action plan describing what action they would take to improve the support provided to care workers. The plan included ensuring care workers received at least four supervision meetings and one appraisal each year. The plan also included ensuring that training requirements arising from supervisions and appraisals were recorded and completed.

At this inspection we visited the registered office. We looked at 10 staff files, the training matrix and the training plan. We spoke with the registered manager, the care director and six members of staff.

We have judged the service was meeting the regulation for supporting workers.

We looked at nine care plans and found care was planned and delivered in a way that was intended to ensure people's safety and welfare. People using the service were involved in the assessment and planning of their care. The service had recently introduced a personal profile page to the care plans. One person's relative said, 'The care plan is accurate and I like the personal profile which captures likes and dislikes very well'. We saw that care was planned and delivered in a way which ensured people's safety and welfare.

Care workers we spoke with were positive about the care they delivered. Care workers told us they had been trained in all aspects of care delivery, including safeguarding, whistleblowing, manual handling and infection control. Additional specialised training was provided by district nurses. One care worker said, 'It was a good induction, the director is a good trainer'. We found that care workers were well trained and informed, but lacked regular formal supervisions and appraisals. This meant that staff performance and development was not regularly discussed and actions put in place to ensure staff were supported to develop.

The service had a safeguarding policy. Care workers were trained in recognising and reporting concerns of abuse and were able to describe to us their responsibilities.

The service carried out an annual quality assurance survey with people who used the service and their relatives. We saw that the results had been analysed and actions from people's comments prioritised. We saw that incidents were investigated and logged so that learning could be identified and applied across the service.

People's needs were assessed and care and treatment was planned and mostly delivered in line with their care plans. People's care plans described the care provided but did not include person centred information such as likes, dislikes, preferences or any personal history.

We spoke with people who used the service and they told us they felt safe with the care staff. The provider had an appropriate safeguarding policy and staff had received training. We spoke to staff and only some of them were able to explain clearly the different types of abuse. Information about protecting people from abuse was not shared with people using the service.

Appropriate checks were made before staff were able to start work. We saw evidence of the recruitment, interview and induction process. Staff we spoke with told us that the induction training was good. Most of the people we spoke with felt staff were appropriately trained and competent.

The provider had a fully documented complaints process and log. We looked at the complaints and these were responded to in accordance with the providers policy. People we spoke with told us about complaints they had raised and how these were resolved to their satisfaction.