Classic Care Services was inspected on 8 November 2018 and was announced. We gave the service 48 hours' notice of the inspection visit because we wanted to make sure key staff would be available to speak with us. Classic Care Services is a domiciliary care service situated in Crawley, West Sussex. It provides personal care to adults living in their own houses and flats in the community. Some people using the service were living with dementia and physical disabilities. At the time of the inspection there were 47 people using the service. Not everyone using the service receives the regulated activity of personal care; 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 service did not have a registered manager. However, the new manager started at the service on the day of the inspection and told us they planned to apply to register with the Care Quality Commission. 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 on 12 April 2016 the service was rated good. At this inspection on 8 November 2018 the service was rated as requires improvement for the first time.
The provider's approach to quality assurance was inconsistent and systems were not always in place to identify issues in service delivery. Issues we identified at this inspection had not been identified by the provider’s systems. There were audits in place with the aim of ensuring good governance. These were not consistently completed and did not always identify actions taken when issues were identified. Care plans were not always complete or reflective of people’s needs and lacked person centred detail.
Accidents and incidents were not always managed safely. The provider told us that they were not always assured that incidents had been responded to appropriately as they were not managed in a consistent way. People gave mixed feedback about staffing levels which impacted on when they received their care, this resulted in some people experiencing late calls.
People told us they felt safe. A relative told us, “I've never felt that they skimped on the work, I feel he is very safe with them.” People were protected from the risk of harm and staff had a good understanding of safeguarding. Identified risks to people's personal safety were assessed and plans were in place to minimise these risks. People's medicines were managed safely and medicines were administered by trained staff. People were protected from infection control risks.
People's needs and choices were assessed prior to people using the service and regularly thereafter. A member of staff told us, “We always go out and do an assessment prior to people joining the service. It is important to meet people so we get to know them and their needs, it makes the transition more comfortable for people.” People received effective care and support from staff who were well trained and supported within their roles. People were supported at mealtimes to have food and drink of their choice.
People were supported to access healthcare services and staff responded to people's health needs effectively. 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 and their relatives all told us staff were kind and compassionate. One person told us, “The girls are absolutely lovely very kind and very caring.” People and their relatives, if appropriate, were involved in discussions about their care. Care plans were regularly reviewed and people were involved in this process. Staff were respectful of people’s needs and wishes. A relative told us, “They are really kind to both of us I can't praise them enough. I think they are polite, kind, and respectful.”
Staff were responsive to people’s needs. People received personalised care from staff who were person centred in their approach. Staff supported people sensitively at the end of their lives and worked alongside other healthcare professionals to ensure people had a compassionate and dignified death. Within a thank you letter sent to the provider, one relative said, “The care and compassion shown have been a great comfort.”
People and their relatives told us they thought the service was well-led and said they would recommend the service to other people. A relative told us, “I am very happy that they are doing a good job looking after my father.” Staff felt supported and valued by the management team. Staff said the values of the service were to be open and transparent. We observed the management team to be open about the challenges they had faced. People and staff were involved in the service provided, feedback was sought from people regularly and in a variety of ways to ensure people had a say on the service they received.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.