Cera - King's Lynn

People’s experience of using this service:

People felt safe with care staff and care staff understood how to safeguard people from harm.

There was guidance for staff on how to manage risks associated with people’s care and support.

There were enough staff to meet people’s needs. Care visits were occasionally late if they had to be covered because of staff absence. Any issues with staff attending visits late were addressed to improve attendance for the future.

Medicines systems were organised, and people were receiving their medicines when they should.

Staff were provided with equipment such as gloves and aprons and understood how to prevent and control the spread of infection.

Accidents and incidents were monitored and reviewed so that action could be taken to make improvements for the future.

People’s care needs were holistically assessed and included information about health needs, eating and drinking and mobility.

Staff received the training they needed to carry out their role.

The service worked well with other professionals to improve the health and wellbeing of people using the service.

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.

People told us that staff were kind and caring and respected their privacy and dignity.

The service responded to people’s needs and supported people to maintain their independence.

There was a robust complaints procedure in place.

The service was well run, managers were respected and there were systems in place to monitor the quality of care.

There was an open and honest culture where people felt listened to. Feedback from people and staff was used to improve the service for the future.

Rating at last inspection: At the last inspection this service was rated good. (Report published 19 October 2016)

Why we inspected: This was a scheduled planned inspection based on the previous rating.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rating requires improvement.

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

The service had a registered manager in place at the time of our inspection. 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 our last inspection on 3 April 2014 we asked the provider to take action to ensure people’s risk assessments and care plans included information to reduce the risk of people receiving care that was inappropriate or unsafe. During this inspection, we found that the provider had taken appropriate action and improvements had been made.

People were supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People may not receive their care appointment at the time or for the duration they expected. People could not be assured they would receive the support they required to take their medicines safely.

People were provided with the care and support they required by staff who were trained and supported to do so. People provided consent to their care when needed but they may not receive the support required by the Mental Capacity Act 2005 if they were unable to make a decision for themselves.

People were supported to consume a sufficient amount of food and fluids that promoted their wellbeing. People received support from staff who understood their health needs.

People were treated with respect by staff who demonstrated kindness and understanding. People were involved in determining their care and support. They were shown respect and treated with dignity in the way they wished to be.

People were able to influence the way their care and support was delivered and they could rely on this being provided as they wished. People were informed on how to express any issues or concerns they had so these could be investigated and acted upon.

People who used the service and care workers were able to express their views about the service which were acted upon. The management team provided leadership that gained the respect of care workers and motivated them as a team. There were systems in place to monitor the quality of the service and make improvements when needed.

Some of the people we spoke with told us that the provider did not always inform them if their care call was going to be delayed and that this was not their preference.

The provider wrote and told us that improvement actions would be undertaken by 01 November 2013.

During this inspection on 19 February 2014, we found that the provider had taken remedial action and had made the improvements required.

We reviewed 10 people's care records and found that they did not always contain up to date and detailed information in them for staff to deliver safe care and support to people who used the service.

During our inspection on 26 July 2012 we found that the Medication Administration Records (MARS) we saw did not evidence accurate documentation to ensure that people were protected against the misuse of medication. During this inspection on 25 June 2013, we found that the provider had made the required improvements to the recording of medication administration.

The provider had an effective staff recruitment process in place to make sure that people received support and safe care from suitable, skilled, and knowledgeable staff.

Quality assurance procedures were in place for monitoring the quality of the service delivered to ensure that people consistently received safe care and support.

People received the care and support they required to improve their health and well-being. Care records were written and provided adequate guidance to staff members, who knew people's needs well.

People said that they felt safe and that they were happy using the service provided by Mears Care - King's Lynn. They confirmed they would be able to raise concerns with staff members and stated that they felt sure action would be taken. Staff members had an appropriate understanding of their role in reporting abuse and how to support people if this happened.

People received their medicines in a safe way, although medicine administration records were not always appropriately maintained to ensure medicines could safely be given.

Staff members received supervision and training from the provider or from external sources to ensure they had the skills and support to properly carry out their roles and care for people.

There were systems in place to regularly check and monitor the way the service was run.