We carried out a review of the data available to us about Continued Care from Oakville Ltd - Harrogate on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Continued Care from Oakville Ltd - Harrogate, you can give feedback on this service.
About the service
Continued Care from Oakville Ltd – Harrogate is a domiciliary care service providing personal care to people living in their own homes. It provides a service to older adults, people living with dementia, younger disabled adults, adults with a learning disability or autism and children. When we inspected there were 144 people using the service.
Not everyone who used the service received personal care. 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 spoke extremely positively about staff care, kindness and understanding. Managers fostered a culture continually improving, high quality and compassionate care. The provider had continued to introduce innovative practices and new ways of working including throughout the Covid-19 pandemic. For example, the introduction of the electronic system had fostered excellent trust for families and enhanced collaboration and communication. One person told us, “From my experience they are exceptional, they keep good records of everything, communication with me is first class and they have given me peace of mind.”
Effective infection prevention and control systems were in place to protect people. People told us they felt safe and well cared for. They said staff were well trained and had an excellent understanding of their needs and preferences.
Enough staff were employed to meet people's needs in a timely way. Medicines management procedures were in place. People did not report any concerns regarding their medicines.
The provider acted proactively to make sure staff continued to receive training throughout the Covid-19 pandemic. This included training videos on how to use personal protective equipment safely.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture.
Right support
People received personalised support. Staff knew people and understood what was important to them and the best way to provide care to them. People told us staff had developed creative ways to communicate and to increase their self-confidence and maximise independence. “[Name] needs to be stimulated and alert and have fun and they [Staff] do all these things for them.”
Right care:
There was a positive staff culture that was person-centred and inclusive. People received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
Right culture:
The quality of the service provided reflected the need for people with learning disabilities and autism to live meaningful lives that include control, choice, and independence. The service had a strong emphasis on continuous improvement and research was carried out into current best practice.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 15 January 2019).
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Continued Care from Oakville Ltd – Harrogate on our 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 re-inspection programme. If we receive any concerning information we may inspect sooner.
Continued Care from Oakville Ltd – Harrogate is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people living with dementia, younger disabled adults, adults with a learning disability and children. At the time of this inspection, the service was providing personal care and support to 85 people.
Not everyone using Continued Care from Oakville Ltd – Harrogate receives 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.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager. 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 comprehensive inspection in November 2015 we found the service was meeting requirements and awarded a rating of good. At this inspection we found the registered manager and staff team had developed the service further to achieve an outstanding rating.
The values and culture of the service was exemplified by all the staff who worked in the service. People received personalised care which was exceptionally caring and responsive to their needs and wishes. People were supported by staff with similar interests or where their experience or skills may be of particular benefit. Managers and staff were passionate about providing people with the very best care.
Respect was at the heart of the service’s culture and values and people who used the service reported they felt a tremendous sense of safety and social and emotional wellbeing with their staff. They told us they were extremely happy with and appreciative of the care they received. Comments used to describe staff included, “Exceptional,” “[Name] has a genuine understanding and affection for their work, and, “Full marks all round.”
People who used the service and their relatives spoke extremely positively about the staff who cared for them. Staff were actively encouraged to spend time to reflect on the quality of their practice to support their learning and gain new insights and improve their practice. Staff were highly motivated and offered care and support that was exceptionally compassionate and kind.
Care plans were extremely person-centred. They focused on individual needs and people’s goals and aspirations and how these could be met. People were actively involved in the development of their care plans and the use of technology had been embraced to enable people to access the service’s electronic planning system to check on their visits, send messages and reschedule calls. Staff used a variety of tools such as different languages, sign language and Makaton to communicate with people.
Staff spoke consistently about Continued Care from Oakville Ltd – Harrogate being a good place to work. They described excellent working relationships and spoke enthusiastically about their work and the organisation’s culture and core values. Staff told us the registered manager led by example and encouraged them to use their initiative to ensure people received high quality, personalised care.
The provider had introduced several schemes to recognise and reward staff who had made an outstanding contribution to the care of people who used the service. They had also introduced a welfare and engagement support service to help ensure staff safety and wellbeing was also promoted. Staff were highly motivated and told us they felt extremely valued. A dedicated induction team was used to good effect to ensure the organisation’s core values and culture were embedded, improve staff retention and promote consistent, high-quality care.
Staff had been safely recruited and there were sufficient numbers of staff on duty to meet people’s needs in a flexible way which met their preferences and promoted their independence. People told us they felt safe with staff from Continued Care from Oakville Ltd – Harrogate. Staff had received training in the protection of adults and knew what action they should take if they suspected or witnessed abuse.
People’s medicines were safely managed. 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. Staff members we spoke with fully understood the importance of acknowledging and promoting people’s rights.
People had a wide range of opportunities to provide feedback on the care Continued Care from Oakville Ltd – Harrogate provided. Staff were continually looking at new ways in which they could improve people’s lives. People, relatives, professionals and staff were encouraged to provide feedback on the service at every opportunity with more formal satisfaction questionnaires being distributed annually. A service user forum provided people with the opportunity to meet and give feedback on the service and advise on improvements; this demonstrated a commitment to a process of continuous improvement in the service.
The registered manager had instilled a culture of openness and honesty with staff and people who used the service and their relatives. The culture of Continued Care from Oakville Ltd – Harrogate was one in which staff were encouraged to report any concerns and lessons were learned from any accidents, incidents or safeguarding matters. Quality assurance systems were robust and used make continuous improvements.
Further information is in the detailed findings below.
We undertook this announced inspection on the 24 November 2015. At the previous inspection, which took place on 30 September 2013 the service met all of the regulations that we assessed.
Continued Care from Oakville Limited is registered to provide personal care to people who live in their own home. The service supports people who live in the Harrogate, Knaresborough and surrounding villages. The agency office is situated in a business park in Harrogate. There is parking available at the front of the building. At the time of this inspection the agency was providing support for 164 people. The agency employs 72 care staff and a registered manager.
There was a registered manager at this service. 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.
People told us they felt safe and trusted the care staff who came into their home to support them. They described staff as ‘trustworthy and tremendously good.’ Staff were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary. Staff also told us that the registered manager listened and acted on their feedback. The safeguarding policy was up to date. Appropriate risk assessments were in place to reduce the risk of harm. These were kept under close review and the staff approach was very flexible to allow for changes in circumstances.
The service recruited staff in a safe way making sure all necessary background checks had been carried out. Care workers were organised and deployed in a way that met people’s individual care needs, with small individual teams of staff who knew people well. People who used the service and their relatives told us that they received an individual, consistent and reliable service.
The service had health and safety related procedures, including emergency plans, in place. Staff had regular contact with other healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing. We saw staff had been pro-active where people required medical attention and they were provided with care and support according to their assessed need.
Systems were in place for reporting and recording accidents and incidents, including detailed reviews and actions, were in place. The care records we looked at included individual risk assessments, which had been completed to identify any risks associated with delivering the person’s care. Where people’s needs were complex relevant professionals had been involved to provide advice and training. People gave good examples where staff had acted quickly in accessing medical assistance for them when needed. This meant staff acted quickly and appropriately to ensure their health care needs were met. Records also showed that risks were managed positively, so that people were supported to develop confidence, skills and independence.
Care plans were comprehensively detailed to ensure people’s care needs were met by staff from the service. Some of the people who used the service were supported with taking their prescribed medication and staff were trained and competent to assist people with this. People we spoke with confirmed that they received good support from staff with their medicines and that they always got them or were reminded to take them.
People’s care records showed that their needs had been assessed and planned in a very detailed and person centred way. People who used the service and their relatives told us that they were involved in planning and reviewing their service and that their views were listened to. We saw clear examples where staff had supported people to take positive risks and develop their independence. People we spoke with told us that staff from the service obtained their consent and treated them in a dignified way and always respected their wishes.
We saw exceptional examples of where staff had gone the ‘extra mile’ ensuring people they supported not only received good quality care, but involved them to become less socially isolated and enabled them to continue to live in their own home. We saw where staff had shown great understanding when assisting people living in the community from staff teaching people to re-learn to play the piano again, helping to replace furniture and equipment, where people did not have relatives close by to assist them with this.
People and their relatives told us that staff were caring, treated them well and respected their privacy. Staff were able to describe how they worked to maintain people’s privacy and dignity. We saw clear examples of people being supported to develop skills and independence.
Staff had been provided with training and support to help them carry out their role. This included specialist training and support from relevant health care professionals where someone had complex needs. People who used this service and their relatives told us that staff were competent and knew what was expected of them. Staff told us they were well supported by the registered manager and other managers, who had clear expectations and provided regular support. We saw evidence of staff being encouraged to develop their own professional expertise and there was a strong focus on professional development.
The service supported people in their own homes and provided help with meal preparation, eating and drinking where this had been agreed as part of the person’s care package. If people needed support with eating and drinking this was detailed in their care plan and professional advice had been sought if people had complex nutritional needs. We saw good examples where staff took the initiative and had compassion for people whose appetite was poor. We also saw how pro-active staff were to encourage people to eat and spent quality time with them to ensure this happened.
People had been provided with a handbook about the service, which included the formal complaints process. People also told us that they were given opportunities to raise issues or concerns on an on-going basis. We saw complaints that had been made since the last inspection had been thoroughly investigated and responded to by the service. There were many compliments and letters of thanks.
People who used the service were extremely positive in their comments about the running of the service and the staff. They told us that this was an ‘excellent tailor made service’ with ‘staff supporting people to maintain their independence, enabling them to remain in their own home.’
The service was well-led. The registered manager was very well qualified and experienced. The management team were committed to providing a good quality service. People who used the service and their relatives all told us the service was very well led, with an ethos of providing high quality, person centred care. Staff were passionate about providing high quality services that focused on the individual.
The service had introduced and had implemented the role of ‘staff champions’ in areas such as dementia, medicines, safeguarding people, dignity and respect and disabilities in all of their care teams working for the organisation.
Systems and processes were in place to monitor the service and make improvements where they could. People who used the service, relatives and other professionals were routinely involved in meetings, reviews and on-going work so that their feedback could be taken into account.
There were good auditing and monitoring systems in place to identify where improvements were required and the service had an action plan to address these. Policies and procedures had been updated to ensure they were in line with current legislation.
The service had exceptional systems in place for people who used the service or their relatives to communicate with them. For example a ‘web portal’ had been introduced. This could be accessed remotely from people's own home or their relative's home. This allowed people to access and view the care schedules and see who was attending the visit and to book and amend visits and send messages directly to the rota coordinators. The service also arranged ‘service user forums’. This gave people who used this service the opportunity to meet with other people who also received a service from Continued Care. The service also arranged each year a Christmas Party for people who used the service, which we were told was well attended and thoroughly enjoyed by those people who attended.
The leadership team had an appetite to continually improve the service; one example of this was their focus on work to develop ‘service user champion roles.’ This would give people who used the service opportunity to discuss their ‘user experience’ at the ‘service user forums.’
The organisation continued to be audited both internally and externally to check and set benchmarks to ensure the services practice, quality and standards of care were continually maintained to a high standard. The service had sustained outstanding practice and improvements over time as they held the Investors in People – Gold. The service is also an ISO 9001-2008 accredited organisation.