We carried out this inspection on 16 and 18 August 2016 and it was announced 48 hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. This was the first inspection for the service since registering as a new provider, Cormac Solutions Limited, in October 2015. Cormac Solutions Limited is a company wholly owned by Cornwall Council. The service was last inspected in October 2013, when the registered provider was Cornwall Council; we had no concerns at that time.Bodmin STEPS (Short Term Enablement and Planning Service) is registered to provide personal care to people in their own homes. The service provides care visits for periods of up to six weeks. The aim of the service is to re-enable people to maximise and re-gain their independence, within their own home, after a period of illness and/or hospital stay. The service provides support to adults of all ages. On the days of the inspection the service was providing personal care to 25 people. Referrals for packages of care were made to the service by health and social care professionals. These included; hospital discharge teams, physiotherapists and occupational therapists.
There was a registered manager in post who was responsible for the day-to-day running of the 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 and associated Regulations about how the service is run.
People told us they felt safe using the service. Comments included, “I am very happy with the help”, “Excellent service, I am very satisfied” and “They have been wonderful.”
There were enough staff employed by the service to cover the visits and keep people safe. Rotas were organised into runs of work in specific geographical areas. Staff worked, as much as possible, in areas close to where they lived to minimise travel time and help ensure people had a consistent team of care workers. People told us they had regular staff and the times of their visits were agreed with them. Everyone told us the service was reliable, visits were never missed and they were kept informed of any changes to the time of their visits.
Staff did not rush people and provided care and support at their pace, with a focus on encouraging people to do as much as possible for themselves. People spoke positively about how staff encouraged and helped them gain the confidence they needed to meet their goals. People commented, “Staff give you the confidence to do a bit more for yourself”, “It has been most helpful” and “Staff are helping me to improve.”
Staff were recruited safely, which meant they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.
Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and reablement needs, which meant they were able to provide a personalised service. Care plans provided staff with clear direction and guidance about how to meet people’s individual needs and wishes. Staff spoke passionately about the people they supported and were clearly committed to providing a personalised and caring service in line with people’s agreed goals. Comments from staff included, “It’s great to see how people improve”, “You really feel that you make a difference to people’s lives “and “I love the job.”
People told us they were involved in decisions about their care and were aware of their care plans in which their goals and aspirations were agreed. Care plans provided staff with clear direction and guidance about how to meet people’s individual reablement needs and goals. Care plans were reviewed weekly to evaluate the progress people were making against their overall goals and agree the next steps for the following week. Any risks in relation to people’s care and support were identified and appropriately managed.
Staff and management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
Bodmin STEPS worked successfully with healthcare services to ensure people’s health care needs were met as well as helping people achieve their goals and regain their independence. Healthcare professionals told us they felt staff had the relevant skills and they trusted staff’s judgement when they asked them about people’s care and support needs. Healthcare professionals told us, “Staff are knowledgeable about the people they care for”, “Staff are skilled in their assessment of people’s needs” and “We have always had confidence in their ability to manage people with complex conditions.”
There was a positive culture within the staff team and staff spoke passionately about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The registered manager was also passionate about their role and was clearly committed to providing a good service for people. Staff told us, “I am proud to work for the STEPS service”, “Management and staff all work together as a team”, “STEPS are really good to work for” and “Management listen to your ideas.”
There were effective quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received. Comments from people included, “I would recommend them” and “Excellent service.” People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to.