Archived: Caring Comes 1st Ltd

Caring Comes 1st Ltd is a domiciliary care agency. At the time of the inspection they were providing personal care to 26 people in their own homes. 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:

People told us they felt safe and that staff were kind, supported them in a dignified and respectful manner and maintained their privacy and independence. People received support from staff who they knew well.

People were supported by staff who promoted their independence. People received support from a consistent team of staff who were skilled and competent in providing care and support. Staff and the registered manager showed a genuine interest and passion to deliver personalised care based on people's likes, wishes and preferences.

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. Staff knew people well however some care plans contained basic information relating to people's individual support and care needs.

Communication with health and social care professionals was effective in ensuring people received joined up care. The provider had aims and standards for the service and told people what they should expect from staff and the service in respect of the quality of care they received. The provider worked in partnership with other agencies this supported people in ensuring any changes were raise with professionals and those funding the persons care needs.

Rating at last inspection:

The service was rated good at our last inspection (published 8 June 2017). No changes have been made to the rating of Good at this inspection.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned in line with our inspection schedule or in response to concerns.

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

The service provided personal care support and domiciliary care to people living in their homes in the South Gloucestershire, Bristol and parts of the Bath and North Somerset area. At the time of our inspection a personal care service was provided to 57 people. An additional 18 people were supported with domiciliary care services. The service employed 26 care staff, three service managers and one senior carer. The service was actively recruiting additional care staff in order to meet demand to cover care packages.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was not available for this inspection however the assistant manager, service manager and office based staff supplied all the evidence and information required.

People received a service that was safe. This was because staff received safeguarding adults training and knew what to do if there were concerns about a person’s welfare. They also received moving and handling training so those people who needed assistance to move from one place to another were supported correctly. Staff were recruited following robust recruitment procedures which meant unsuitable staff could not be employed. Any risks to people’s health and welfare were assessed and then well managed in order to reduce or eliminate the risk and chance of harm. Those people who needed assistance to take their medicines were supported to do so safely.

People received an effective service. Assessments were completed prior to a service being provided to ensure staff had the necessary skills and experiences to meet peoples needs. The staff team were well trained, supervised and supported to enable them to carry out their jobs effectively. Staff were given clear instructions about the people they supported. People were provided with support to have food and drink where this had been assessed as part of their care package. People were supported to access health care services if needed.

People received a caring service. Feedback received from people who used the service, relatives and health and social care professionals was overwhelmingly positive. People were treated with kindness and respect and the staff were kind, caring and enjoyed their job. Staff spoke about the importance of having good working relationships with the people they supported and the service manager ensured compatibility of staff and people as part of their rostering duties. People were encouraged to have a say about how they were looked after and the way the service was delivered.

People received a service that was responsive to their individual care and support needs. People’s needs were assessed and then a package of care put together that met those needs. Their preferences and choices were respected. People were provided with copies of their plans and their support package was regularly reviewed. The delivery of care services was adjusted as and when needed.

People received a service that was well-led. The registered manager, assistant manager and service managers provided good leadership and management for the care staff. There were regular checks in place of the quality and safety of the service in order to identify where any improvements could be made or changes were required. The recent changes in the staffing structure had been put in place to allow the service to expand and support more people to live in their own homes.

This report only covers our findings in relation to these specific areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Caring Comes 1st’ on our website at www.cqc.org.uk.

At the time of this inspection the service was providing support to 56 people who lived in their own homes. The areas they covered included South Gloucestershire and Bath and North East Somerset (BaNES).

The service has 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 and associated Regulations about how the service is run. At this inspection we found improvements had been made. We looked at how the service was managing support to people with their medicines and the processes in place to assess and monitor the quality of the service provided.

The improvements required in respect of the support people received with their medicines had been put in place. The records provided clear details about how people were to be supported with specific instructions for the care staff to follow. Appropriate records were kept to clearly evidence the support that had been provided.

Systems and processes had been put in place to obtain the views of people using the service, friends and families, and the staff team. Actions had been taken where improvements had been suggested.

Any accidents, incidents or complaints were monitored and analysed in order to identify themes. This enabled the registered provider and registered manager to make changes, prevent or reduce reoccurrences and drive improvements. These measures helped to monitor the quality and safety of the service.

The two breaches of regulations have been addressed.