We undertook an announced comprehensive inspection on Wednesday 30 March 2016. We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service and we needed to be sure that someone would be at the agency office that could assist us with the inspection. This service was registered by CQC on 12 October 2015 and this was the first inspection for this location.Able Carers York/Harrogate is registered to provide personal care for people with a range of varying needs including dementia, learning disabilities or autistic spectrum disorder, mental health, older people, physical disability, sensory impairment and younger people who live in their own homes.
At the time of our inspection, 76 people received a personal care service. The service provides domiciliary care and support services from the registered office location, on the outskirts of York.
The registered provider is required to have a registered manager in post and on the day of this inspection, there was a registered manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 who used the service told us they felt safe and we found that care workers knew how to protect people from avoidable harm. Risk assessments and risk management plans were in place and they were regularly reviewed and updated in line with the person’s needs.
Accidents and incidents were appropriately investigated and recorded with clear details of investigations and actions taken to help prevent re-occurrence.
The registered provider had a robust recruitment process in place including sufficient checks to help ensure that the care workers recruited were considered suitable to work with vulnerable people. We saw care workers underwent an induction programme followed by a supervised introduction to people. People told us they received consistent care from care workers who they knew.
Where people required support with their medication this was provided appropriately. Risk assessments were completed and training provided to care workers to help them ensure that they followed the agency’s policies and procedures. Care plans included protocols for medicines, which were prescribed for people with specific conditions.
Care workers told us they felt well supported and we saw good communication and relationships between care workers, management, people who used the service and outside agencies such as the local authority and health workers.
The registered provider had a training plan in place and we saw that this was managed and recorded electronically to ensure that they had the up to date skills they needed to carry out their duties effectively. Competencies were annually reviewed. Training included safeguarding, moving and handling, medicine management and health and safety. Person centred training was provided for care workers to meet people’s individual needs and included diabetes, dementia and Parkinson’s disease.
Training was available for care workers in the Mental Capacity Act 2005 and the registered provider had a policy in place. Care workers had a basic understanding of the MCA and they understood the importance of people being supported to make decisions for themselves.
The registered manager told us care workers do not receive training in the Mental Health Act. They told us they refer any concerns or changes in people’s behaviour to the Community Mental Health Team (CMHT). They told us they were looking at further training for care workers in mental health awareness.
People received support with eating and drinking. Support was varied dependent on their individual circumstances. Appropriate professional advice was identified where necessary to ensure people’s health needs were supported.
People told us that the service was responsive to their needs. We saw that care plans were person centred and focused on the individual needs of the person being supported. They included peoples’ preferences, likes and dislikes. All of the people we spoke with confirmed that they had been involved in discussions regarding their care.
The registered provider had a compliments and complaints policy and procedure. People said they were confident in raising concerns. Each person was given a copy of the complaints procedure. People told us that complaints were listened to and resolved. Care workers told us they knew how to complain and that they were confident any complaints would be listened to and acted on.
We saw that the registered provider worked effectively with external agencies, other health, and social care professionals to provide consistent care to a high standard for people. This ensured that they were responsive to people’s changing needs.
New care workers had undertaken training in end of life care. The registered provider had a schedule of training planned for April 2016 so all care workers were able to support people with their wishes and preferences and ensure that people were treated with dignity, comfort and respect at the end of their life.
People and care workers we spoke with told us they thought highly of the management and told us they were happy with the way the service was managed. The registered manager understood how to meet the conditions of their registration with the Care Quality Commission (CQC).