Cygnet Care (Devon) Limited

At the time of inspection, there were 37 people receiving a service from the agency. Although the majority of people using the agency received a regulated activity, six received support visits only. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The time of visits ranged from 15 minutes to two hours and 15 minutes, with the frequency of visits from once a week to six times a day. There was one person who required two care workers at each visit to support them. There were 14 full and part-time staff employed.

There was registered manager in post. A registered manager is a person who has registered with the 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.

At the last inspection, the service was rated as good in five areas, with an overall rating of good.

At this inspection, we found the service remained good in four areas and outstanding in one area. The overall rating remained good.

The registered manager and care workers provided people with a bespoke service and delivered care and support which took into account people’s individual choices and preferences. People were very happy with the service they received. Care workers treated people with respect, dignity and compassion at all times. Meaningful relationships had been developed with the care workers who supported them. Families, friends and pets were involved in their care, support and wellbeing. A relative said, “My (family member) is very happy to see her ‘friends’ (care workers) and appears to be more relaxed after their visits” and a friend said “(Friend) feels very comfortable with your carers and looks forward to (care worker’s) visits very much.” People were encouraged to be as independent as possible by care workers they trusted and felt safe with.

Care workers supported people to lead an enhanced quality of life. People commented, “During the time carers came to help (family members), the care and time given has been wonderful. They both enjoyed their carer’s visits and were always happy with the care given … more like friends”; “All the carers are really good”, and “They will do anything.” People said care workers went ‘the extra mile’ and the agency put people at the heart of their service. The agency went above and beyond what was expected of them and due to the small size of the agency, delivered a personal service where the registered manager knew each person extremely well and visited them regularly. Caring for people’s wellbeing was an important part of the agencies philosophy. Care workers regularly carried out duties over and above what was expected from them.

Meaningful relationships had developed between staff, people and their relatives. Friends and family were involved in people’s care and spoke highly of the agency. People had a regular team of care workers and felt they had become part of the extended family.

People were kept safe and cared for by care workers who were aware of their safeguarding responsibilities. Care workers were safely recruited, trained and supervised in their work. They enjoyed their jobs, felt included and listened to in the running of the agency.

People had confidence in the management of the service and the registered manager acted as a role model for the staff team. People were confident any issues would be dealt with appropriately. One person commented, “(Registered manager) is a lovely kind person … we were recommended for this service.” A health care professional said, “They provide excellent care to our clients in a very professional manner.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Care workers had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support.

Each person had risk assessments and a care plan in place. People and their families were involved in the planning of their care and these were regularly reviewed. When changes in care support were required, these were carried out in a timely way. A relative commented, “I would like to say a big ‘thank you’ for everything you did to accommodate the ever changing needs of my parents … it was so reassuring for me to be able to talk to you knowing that you would do all that you could to help.”

Care workers had been trained to give people their medicines safely and ensured medication administration records were kept up to date. Care workers supported people to eat a nutritious diet with food and drinks of their choice. In between care visits, care workers always made sure people had snacks and drinks available.

People we spoke with told us they were very happy with the service they received from the agency. One person told us "I was concerned about people coming into my home but I could never have imagined just how well it works ". A member of staff told us 'I don't look upon what I do as a job because I love it so much. I get so much out of helping others it's amazing'.

We saw that people had specific and individualistic care plans. These had been updated daily in accordance to people's wishes. Support staff had been provided at a level required by the individual and their families and promotion of independence was evident. Staff had all received a thorough core training programme that included safeguarding and attended regular updates.

There were sufficient support workers to meet people's needs and appropriate background checks had been completed on all staff. Audits were in place to continually monitor and assess the quality of care and support provided.

We found that people were very happy with the staff and the care that was delivered. One person said about their carers, 'They are excellent ' I would recommend them to my friends.' They told us about extra things that staff had done for them.

People told us the agency had sent them regular lists of the staff who would be coming to them. This reassured people, as they knew who would be coming.

'I'm thrilled to bits,' another person said. 'Ever since they've been coming to me nothing's been too much trouble.'

We saw that staff were given detailed guidance on how people preferred their care to be provided. We saw that people had signed their own care plans, and people confirmed that staff were responsive to their needs as well as reliable.

One person said that the managers and staff all understood their complex problems and made them feel at ease. They were able to discuss any problem that arose, however personal or difficult.

We saw that staff had called for help from District Nurses (DNs) when they saw a problem develop that needed nursing care, and had worked with other health care professionals to ensure people received the services they needed.