Shirecare

Updated 21 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of two inspectors and one Expert-by-Experience. An Expert-by-Experience is a person who has had personal experience of using or caring for someone who uses this type of care service.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours' notice of the inspection. Inspection activity started on 26 November 2019 and ended on 27 November 2019. This is when we contacted people who used the service for their experience and spoke with some staff. We visited the office location on 30 November 2019 and met with the management team.

What we did before the inspection

We reviewed any notifications we had received from the service (events which happened in the service that the provider is required to tell us about). We reviewed the last inspection report. We asked Healthwatch Nottingham for any information they had about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with four people who used the service and seven relatives about their experience of the care provided. We spoke with the registered manager, the nominated person(provider) nine care staff, the provider's trainer and two care coordinators. We reviewed a range of records. This included seven people's care records. We looked at four staff files in relation to recruitment. We reviewed a variety of records relating to the management of the service, including staff training, audits and checks.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We asked the registered manager to provide us with details of policies and procedures. Information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.

Updated 21 December 2019

About the service

Shirecare is a domiciliary care agency. It provides personal care to people living in their own homes within and around Nottingham and Derby. It provides a service to older and younger adults living with a range of health conditions and needs, to live independently in the community. Not everyone using Shirecare receives a regulated activity; 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. At the time of our inspection, 56 people were receiving personal care as part of their care package.

People's experience of using this service and what we found

Improvements had been made to the systems and processes that monitored the quality and safety of the service. Further work was required to implement ways of analysing incidents and late or missed calls for themes and patterns to support any learning opportunities. The registered manager took immediate action during the inspection to address this.

Improvements had been made to how medicines were managed. Action was still required to ensure hand written medicine administration records, were checked and signed by a second staff member to avoid mistakes being made. During the inspection the registered manager took action to address this. Following the inspection, the registered manager confirmed this had been completed and a new system had been introduced.

Whilst every effort was made for people to receive care from regular staff at the times they wanted, a reoccurring theme from people was they had experienced late calls. Three people reported they had experienced a missed call; however this could not be evidenced.

People's needs, preferences and routines were assessed and acted upon. Guidance provided in care plans for staff had been improved upon. However, guidance and information were not consistently detailed.

Risks associated with people’s care needs, including the environment had been assessed and staff had guidance of how to manage any known risks. Staff had received training in safeguarding adults and the registered manager was aware of their role and responsibilities to act on any safeguarding concerns.

Staff recruitment was ongoing and at the time of the inspection, sufficient staff were deployed to meet people's care needs. Robust checks were completed on staff's suitability to provide care before they commenced their employment.

People were protected from the risk of cross contamination because best practice guidance in infection control practice was followed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received an induction and improvements had been made to the training staff received. Staff had spot checks completed to review their practice to ensure standards were maintained.

People were supported with their health care needs. Staff monitored people's health and care needs and shared information with healthcare professionals when required. Where people required assistance with nutrition and hydration needs, staff had detailed guidance of the support people required.

People were complimentary about staff and considered them to be kind and caring. At the time of the inspection no person was receiving end of life care, however staff had received training in this area of care. People received care and support that respected their privacy and dignity. People's communication and sensory needs were assessed.

The providers' complaints procedure had been shared with people and people received opportunities to share their experience about the service.

The registered manager and provider understood their registration regulatory responsibilities.

Rating at last inspection

The last rating for this service was Requires Improvement (published 31 October 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations. The service has improved to an overall rating of Good. Responsive remains Requires Improvement, further action is required to ensure people receive a service that is consistently responsive.

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.