Facilitate Care Services

Facilitate Care is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of this inspection the service supported 153 people with personal care.

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 told us the care they received met their needs. They felt safe with the staff that supported them and described the care provided by staff as good.

People and their relatives were involved in planning and reviews of their care although face to face reviews had not routinely taken place due to the COVID-19 pandemic. People were supported by a consistent group of staff which meant staff knew people well. Basic risk management information was included in people's plans of care. Staff had completed some training in relation to the specialist care needs of people they supported. Where there were gaps in specialist training, records did not always support staff with guidance on how to respond to people’s needs. Audit systems were not fully effective in identifying gaps in records. However, the lack of clear records had not impacted on people’s care.

People were happy in relation to how they were supported with medicines and staff told us they knew how to administer medicines safely. Medicine records however, needed improvement to clearly show how medicines were managed.

Staff felt valued and supported by the management team and spoke positively of working for the service. Staff were recruited in a safe way and there was regular management contact with staff to identify any support needs they may have such as training. Staff had received training on how to protect people from the risk of abuse and understood the importance of reporting concerns. The provider understood their legal responsibilities in acting on and in reporting any such incidents. Staff followed the provider’s infection control policies and had access to the personal protective equipment they needed to help prevent the risk of the spread of infection.

There were systems in place for people to give their feedback on the service. The provider had identified some areas where improvements were needed.

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 Requires Improvement (published 10 May 2019).

Why we inspected

The inspection was prompted in part due to concerns we had received in relation to lack of staff knowledge and safe care practice in regards to people’s specialist care needs. We also received concerns regarding gaps in care records making it difficult for staff to know if care had been delivered safely. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Facilitate Care Services 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.

People’s experience of using this service:

• People felt safe from avoidable harm. People felt at ease to raise safety risks with the registered manager for them to be resolved.

• Risks related to people’s health were identified and acted upon by staff. However, records were not always clear to show risks were managed.

• People’s needs were assessed before they started to use the service to make sure their needs could be met. • Most people were happy with the care and support they received and spoke positively of the service. However, care records, including medicine records, lacked detail to confirm care and support was managed safely.

• Enough staff were available to support people’s needs and staff knew people well.

• Staff were allocated to work in specific areas so that people experienced some consistency in the care staff that supported them.

• Recruitment records were not always detailed to confirm safe processes were followed.

• People told us they received their medicines as required.

• Staff completed regular training to ensure they cared for people safely and effectively.

• People were supported to be independent and were asked for their consent before care was provided.

• People were supported with food and drinks as required.

• People and relatives felt staff were caring and respectful in their approach.

• People knew how to raise a complaint and records were kept of concerns raised.

• There were quality monitoring systems to test people’s views of the service and these had resulted in some improvements.

• Staff felt valued and supported by the management team and spoke positively of the support they received.

Rating at last inspection: At our last inspection we rated the service as Requires Improvement overall. The report was published on 24 April 2018.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with the Care Quality Commission scheduling guidelines for adult social care services.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

Facilitate Care Services is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of our inspection, 58 people were supported with personal care.

The service had 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.

The service was last inspected in July 2016, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At the last inspection the service was rated ‘good’ overall, with ‘well led’ rated as ‘requires improvement.’ At this inspection we found improvements were required in how medicines were administered, and how risks were assessed and managed. Improvements were also required in how the provider checked and audited the service to ensure this was done effectively.

People did not always have their medicines administered safely and as prescribed. There were gaps in medicine administration, and mechanisms in place to record and audit when medicines were given were not effective which put people at risk.

Risks to people’s safety were identified, but risk assessments had not always been completed. Where these had been completed, they did not always give staff the information they needed to ensure risks were managed consistently.

People told us they felt safe with the staff who supported them. Staff received training in how to safeguard people from abuse and were supported by the provider who ensured staff followed safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. People were protected from the risk of infection.

There were enough staff to meet people’s needs safely. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people. Staff told us they had not been able to work until these checks had been completed.

People told us staff asked their consent before undertaking any care tasks. Where people were able to make their own decisions, staff respected their right to do so. People’s care records included some information on the support they needed with decision making.

Staff had the right knowledge and skills to support people effectively, and this was monitored by the provider. Staff had some access to supervision meetings to keep up to date and discuss their practice, though these meetings had not always happened as often as the provider’s policy and procedure required.

People had access to health care professionals when needed and care records showed support provided was in line with what had been recommended.

People and most relatives told us staff were respectful and treated people with dignity. Staff respected people’s privacy, and supported people to be as independent as possible.

People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, their likes, dislikes and preferences. People and most relatives told us the provider responded to requests to adapt their care effectively.

People and most relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way.

Systems to check and audit the quality of the service provided had either not been used or, where they had been used, had not been effective. They had not identified the issues we identified during our inspection visit. The provider ensured they took action following our inspection visit on the concerns we identified.

People, most relatives and staff were positive about the provider, and staff told us they were well supported. The provider had sought feedback from people and their relatives, and had taken action in response to what had been identified.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Facilitate Care Services is a domiciliary care agency that provides personal care and support to people living in their own homes. Care staff call at people’s homes to provide personal care and support at set times agreed with them. At the time of our inspection there were around 25 people who received personal care through Facilitate Care Services.

During the inspection we met with the registered manager and provider. 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 when supported by care staff. Staff understood how to protect people from abuse and knew about risks to people’s safety. They told us they reported any concerns they had to the staff based in the office so they could be acted upon. This ensured potential risks to people were managed appropriately. All care staff had been provided with a staff handbook containing information about the policies of the provider and what was expected of them when working for Facilitate Care Services. This helped to ensure they provided safe and effective care to people.

Care staff received training on how to manage medicines safely. People told us staff mostly prompted them to take their medicines to make sure they took them. Medication audit checks ensured medicines were managed appropriately.

Checks were carried out prior to care staff starting work to ensure their suitability to work with people who used the service, although these checks were not always clearly recorded. New care staff completed induction training and shadowed more experienced care staff to help develop their skills and knowledge. Staff completed training on an ongoing basis and were about to commence training to achieve the Care Certificate to help develop their skills.

People received a service based on their personal needs and staff usually arrived to carry out their care and support within the timeframes agreed. People were positive about the care they received from staff. People told us staff maintained their privacy and dignity and supported their independence. They commented that staff were respectful and caring in their approach.

People’s nutritional needs were met by the service where appropriate. People who were reliant on care staff to assist with meal preparation said the staff would prepare meals and drinks of their choice.

The registered manager understood the principles of the Mental Capacity Act (MCA) and how to put these into practice. Care staff told us they gained people’s consent before giving care.

The provider had some processes in place to monitor the quality of the service and to understand the experiences of people who used the service. This included regular communication with people and staff, and the use of ‘feedback’ forms to assess people’s views of the care and service they received. People knew how to raise concerns if needed and those people who had done so, felt they had been managed and resolved to their satisfaction.

We found overall that records were not always sufficiently detailed to demonstrate the processes and systems in place to ensure quality care and services were provided.