Archived: Truro STEPS

Updated 28 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 27 and 28 June 2016 and the provider was given 48 hours notice of the inspection in accordance with our current methodology for the inspection of domiciliary care agencies. The inspection team consisted of one inspector.

We reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we went to the service’s office and spoke with the registered manager, the office support worker and three team leaders. We visited two people in their own homes and during these visits we met two relatives. We looked at six records relating to the care of individuals, staff records and records relating to the running of the service. After the visit to the service’s office we spoke with six people, six staff and three health and social care professionals over the telephone.

Updated 28 July 2016

We carried out this inspection on 27 and 28 June 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 April 2014, when the registered provider was Cornwall Council, we had no concerns at that time.

Truro 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 30 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 commenting, “I am very happy with the service”, “I am getting wonderful care from them”, “I haven’t had a bad experience at all” and “Excellent service.”

People told us staff were kind, caring and compassionate; whilst being respectful of their privacy and dignity. Comments from people included, “The carers have been very conscientious and cheerful”, “Staff have been very helpful”, “Staff always have a chat with me” and “They [staff] are very nice, they treat me kindly.”

People told us they had a team of regular, reliable staff, they knew the times of their visits and were kept informed of any changes. No one reported ever having had any missed visits. People told us staff did not rush them and provided care and support at their pace, focusing on enabling them to do as much as possible for themselves. People praised staff on how they were always cheerful, encouraging and helped them gain the confidence they needed to meet their goals. People commented, “They [staff] have kept me going, they are competent and encouraging”, “Staff will always do extra things for me” and “You built up a relationship with staff, which gives you confidence to try new things.”

Staff were knowledgeable about the people they cared for and responded appropriately as people’s needs changed. The registered manager ensured staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. Staff spoke passionately about the people they supported and were clearly motivated to deliver a responsive and caring service in line with people’s agreed goals. Comments from staff included, “It’s great to see how people improve” and “The service is about helping people to get their confidence back.”

People were involved in decisions about their care and staff encouraged and empowered them to achieve their goals. 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 had been 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. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

The 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.

The registered manager and staff worked with healthcare professionals to develop individual care plans and exercise programmes to help people achieve their goals and regain their independence. Heathcare professionals told us, “I have always found the service to be professional in their dealings with us, as well as being open to discussion in regards to the needs of people and how to achieve the best outcome for them”, “I have confidence in the team, they listen to my instructions” and “The STEPS service is invaluable to the stroke team, very responsive and patient focused.”

There was a positive culture in the service, the management team provided strong leadership and led by example. The registered manager had clear visions and values about how they wished the service to be provided and these values were shared with the whole staff team. Staff told us,

“The organisation is brilliant, they treat us well” , “Very good to work for” , “I am proud to do my job” and “They [management] support us really well.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families told us the management team was very approachable and they were included in decisions about the running of the service. People had details of how to raise a complaint if they needed to but felt that issues would usually be resolved informally. Comments from people included, “I couldn’t recommend them enough”, “Very happy to use the service again” and “I would recommend them to anyone.”