Just Ask Care and Support Community Interest Company

Just Ask Domestic Services Community Interest Company is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 33 people using the service. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

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.

Systems were in place to help safeguard people from abuse. Procedures were in place to guide staff should they have any concerns. Risks to people and staff were identified and well managed. There were safe systems of recruitment in place and sufficient staff deployed to meet people's needs. Staffing and visits were well organised. There were systems in place for the safe administration of medicines. Risks associated with COVID-19, and other infectious diseases, were identified and well managed.

People’s needs were assessed prior to them starting using the service. Assessments were thorough and reflected what was important to and for the person. Staff received the training and support they needed to undertake their roles. Staff and managers worked well with other professionals.

Staff and managers knew people really well. They spoke about people in respectful and caring ways. People spoke very highly of the staff and the care and support they received. One person said, “I did not expect them to all be so lovely. They are very caring.” People, and where required their relatives, where involved in all decisions about their care and support.

Care and support were designed around each person’s needs, wishes and preferences. Companionship visits were used to offer people activities and help with emotional well-being. These were arranged when staff had time due to other people cancelling visits. People told us they knew how to complain but said they didn’t have any complaints. One person described the service and staff as; “Professional, friendly, courteous, dependable, reliable and flexible each and every one.”

There was a range of oversight, quality monitoring and auditing. Managers had a clear vision and commitment to good quality care and support that valued people who used the service. Staff spoken with and records reviewed showed staff shared that commitment. People told us the service was well managed and that they would recommend the service. A family member said, “I would totally recommend them. From start to finish, top to bottom, it’s what care should be. Person-centred focus, the ambiance and atmosphere are impeccable. Wonderful value for money. Totally trustworthy, I do not need to be there. I have total confidence in them.”

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

Rating at last inspection.

The last rating for this service was good (published 20 December 2017).

Why we inspected

The inspection was prompted by the length of time since our last inspection. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Just Ask Domestic Services Community Interest Company on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection in December 2016 we rated the service as 'requires improvement'. We identified breaches in Regulations 11, 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Just Ask Domestic Services Community Interest Company provides personal care and support to people who live in their own homes. The company is a community based, not for profit organisation. The service supports people who need support with tasks such as shopping, washing, dressing and medicine administration. The regulated activity is personal care, and at the time of the inspection, the service provided personal care to 16 people.

At this inspection we found the provider had made significant improvements and was no longer in breach of the Regulations. However, further improvement was required to become well-led.

At the time of our inspection, there was still not a registered manager in place. 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. The service has been absent of a registered manager for over a year.

The registered provider had good oversight of the service and was aware of areas of practice that needed to be improved. There were systems in place to look at the quality of the service provided and action was taken where shortfalls were identified. However, there was a lack of clarity between the roles and responsibilities of the registered provider and manager. We recommend the registered provider review responsibilities with the new manager so there are clear expectations for each of their roles.

People told us they felt safe at the service. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. There were good systems in place to make sure that people were supported to take medicines safely and as prescribed.

Risks to people had been assessed and plans put in place to keep risks to a minimum. An ‘out of hours’ service was in place so people could contact a member of staff in an emergency.

There were enough staff on duty to make sure people’s needs were met. The provider had robust recruitment procedures to make sure staff had the required skills and were of suitable character and background.

Staff told us they enjoyed working at the service. Staff were supported through training, regular supervisions and team meetings to help them carry out their roles effectively. Staff were supported by an open and accessible management team.

The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put in place to protect people where their freedom of movement is restricted.

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

Care plans were person centred and showed that individual preferences were taken into account. Care plans gave clear directions to staff about the support people required to have their needs met. People were supported to maintain their health and to access health services if needed.

People’s needs were regularly reviewed and appropriate changes were made to the support people received. People had opportunities to make comments about the service and how it could be improved.

This inspection took place on 14 December 2016 and was announced. This was the first inspection of the service which was registered in May 2015.

Prior to this inspection we received information from the local authority regarding concerns about the service following a quality monitoring visit.

There was no registered manager in post at the time of our inspection, which is a condition of the provider's registration. 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. The manager in post had started the process to register with the CQC.

During the inspection we found breaches in the Regulations relating to good governance, fit and proper persons employed, and staffing. You can see what action we have asked the provider to take at the back of the full version of the report.

There was a lack of experienced management and clear leadership within the service. Complete and accurate records, in relation to the care and support that people received, were not maintained. This included records relating to risk management, medicines, mental capacity and team meetings. This presented a risk to people of receiving inappropriate care and treatment. The provider did not have systems in place to assess and monitor the quality of care they provided.

Recruitment procedures were not being followed and there was not a robust system for checking the backgrounds of staff before they started work. Some staff were working without references or background checks. The lack of a robust process for checking that staff were ‘fit and proper’ placed people who used the service at risk of improper care or support.

There were gaps in training and care staff did not receive a formal supervision. This meant that staff were not fully supported in their development and did not have opportunities to learn about wider areas of good practice.

The systems in place for the administration of medicines did not make sure that medicines were safely managed. Risk assessments and information about how to reduce risks was not always in place where risks to people had been identified.

Although the provider considered issues of capacity and consent, documentation was not always clear. Where people had capacity to make their own decisions the provider had not always gained consent before providing care and support.

People told us that they received good support from caring staff, who supported them in the way they wanted. People were supported to maintain good health, and the service worked closely with other professionals where necessary.

The manager and registered provider were open and receptive throughout the inspection. They accepted the situation required urgent improvement. The provider has decided to suspend new placements while improvements are made. Staff told us that there was a supportive working atmosphere and that they like working for the provider.

Following the inspection we shared our findings with the local authority. An action plan has since been received from the registered provider, in relation to the concerns identified at the local authority quality monitoring visit which took place in November 2016.