Chesterford Homecare

Updated 12 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was undertaken between the 5 and 13 November 2018. The inspection was announced. We gave the service notice that we would be doing the inspection so that they could make sure the necessary people were available at the office when we called. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service, and their expertise was in the care of older people.

Before the inspection, the service completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also sent out questionnaires to people who use service and staff about their experience of the agency. We had 18 responses from people who used the service and their relatives, nine responses from staff and one professional.

In advance of our inspection we reviewed the information we held on the service, in particular notifications about incidents, accidents and safeguarding information. A notification is information about important events which the service is required to send us by law. We looked at safeguarding concerns reported to us. This is where one or more person’s health, wellbeing or human rights may not have been properly protected and they may have suffered harm, abuse or neglect.

As part of the inspection, we spoke to four people who used the service and six relatives. We undertook visits to two people who received care in their home. We spoke to staff both in person and by telephone; in total we spoke with eight care staff as well as three staff from the head office team, including the registered manager and provider.

We visited the office on 5 November 2018 and reviewed a range of documents and records, including care records for people who used the service, records of staff employed, complaints records, medication, accident and incident records. We looked at a range of quality audits and management records.

Updated 12 December 2018

Chesterford Homecare is a domiciliary care agency and provides care to people living at home in the community. This service provides both live in carers and visiting carers and supports older people, people living with dementia and adults with a physical disability. Chesterford Homecare was previously known as Audley Homecare and at the time of our inspection there were 27 people using the service, of which 13 people were in receipt of personal care.

There was a registered manager in place who had been registered since the last inspection and was present at the inspection. 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 had its last comprehensive inspection in September 2017 and we identified a number of concerns and rated the service ‘requires improvement.’ We asked the provider to take action in response to our findings. At this inspection we found that the provider had addressed the concerns that we identified.

At our last inspection quality assurance systems had not always been effective in recognising and rectifying issues and where people’s views about the service had been obtained there had been no analysis of the feedback. At this inspection we found that audits on practice and on documentation had been undertaken on a regular basis and the information used to drive improvement at the service. People’s views about their experience of using the service had been obtained, the results analysed and actions taken to address the issues identified. The results showed that people had confidence in the service and the quality of care provided. People’s comments, including both positive and negative had been published along with the actions taken which demonstrated an openness and transparency.

At our last inspection we found that the systems in place for the recruitment and selection of staff were ineffective and recruitment checks had not routinely been carried out before staff started their employment. At this inspection we found that improvements had been made and appropriate checks were undertaken on staff prior to their employment to ensure they were suitable to work with people using the service.

At the last inspection we found that not everyone had an up to date care plan which guided staff as to their care and support needs. Risks to people’s wellbeing had not always been clearly identified and actions taken to minimise these. At this inspection we found that improvements had been made. People's needs were assessed prior to the commencement of care and the information used to develop a detailed and informative care plan to guide staff. The care plans were person centred and people’s care needs were regularly reviewed and plans amended as required. Staff were provided with guidance about how risks should be managed and steps that staff should take to reduce the likelihood of harm.

There were sufficient staff employed and people told us that they received care from a consistent team of staff who knew them well. There were clear systems in place for people and staff to seek advice and support out of hours. On the occasions where the service used staff from another agency we saw that they asked the other care agency to provide information on the staff as to their suitability.

There were systems in place for the management of safeguarding concerns and staff were clear about the actions that they should take if they had a concern.

There were procedures in place to guide staff in the administration of medicines and regular audits to check that people were receiving their medicines as prescribed. During the course of the inspection we identified a small number of anomalies with medicines and the registered manager responded to these by strengthening the auditing process.

Staff had received training which provided them with the necessary knowledge and skills. Staff performance was monitored to ensure that they were working to the required standards and regular staff meetings were held. Staff told us that they were well supported and the management of the service was approachable and helpful.

People were supported by staff who were described as being kind and caring. Staff enabled people to make choices and remain in control of the decisions around their care.

People were supported to eat and drink in line with their preferences and needs. Where there were concerns about people’s nutritional intake there was a clear plan in place as to how this should be managed and monitored. People had good access to health care support when they needed it. The agency sought advice appropriately from health professionals when people’s needs changed.

There was a complaints policy in place and people’s concerns were investigated. People told us that they felt comfortable raising concerns.

Management information was collected and analysed to identity areas for improvement. For example, when incidents took place, the registered manager reflected on what happened to ensure that issues were identified, and where appropriate information was shared with staff and people who used the service.