Archived: Faiths Care

Faiths Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. These include older people, people living with dementia and people with a physical disability. At this inspection, there were 35 people being supported by Faiths Care.

At the previous inspection in November 2016 the service was rated requires improvement overall and we found five breaches of the regulations. This was because the service did not ensure that people had care plans in place that were up to date and held the right information. The service had not ensured that medicines were dispensed and recorded properly. People did not always have access to the services' complaints procedure and could not be confident that their complaints would be dealt with to their satisfaction. There was not always sufficient staff to care for the people who used the service and to enable the provider to run the service effectively.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service to at least good. The provider sent us an action plan after the inspection outlining the actions they were taking in response to our concerns.

At this inspection we found the necessary improvements had been made and the service has been rated good overall.

The service had 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 2008 and associated Regulations about how the service is run.

The registered manager had recruited a new general manager and field care supervisor since our last visit. This management team worked extremely well together and were key to the improvements at the service. Staff were enthusiastic and committed and people gave us positive feedback about the service they received. The registered manager had extremely high standards and expectations. There were regular checks on the quality of the care provided and the management team dealt with poor practice promptly. They used information from feedback and mistakes in a positive way to improve the care provided. This was a relatively new service and the registered manager was still developing formal systems to log and analyse themes over time.

People’s safety was a priority and they received consistent support from staff who knew them well. Improved recruitment practices and well organised rotas meant staff were not rushed. They had good information about people’s individual needs and guidance about how to minimise risk. Good communication and planning meant people continued to receive safe care when their usual care staff were not available.

The registered manager ensured any risks from the spread of infection were minimised by requiring staff to have scrupulous cleaning practices. People received their medicines safely and were encouraged to remain independent in this area where possible. Staff had clear guidance about any specific risks when supporting people with their medicines.

There was an effective and established staff team who had the necessary skills to keep people safe. Training had improved, and staff were well supported and monitored. 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. The management team and care staff communicated well with outside professionals and were committed to supporting people to remain healthy and access outside services where required.

Staff had enough time to care for people and develop compassionate relationships with them and their families. People’s wellbeing was a priority staff communicated with them to ensure their views shaped the support they received. Staff upheld people rights and provided care which was dignified and respectful.

The support provided was person-centred and flexible, taking into account peoples’ preferences and individual circumstances. Care plans had been revised to provide clear guidance to staff. People’s care needs were regularly reviewed and plans amended as required. People felt able to complain and be confident their views would be listened to and acted on. They benefitted from the improved culture at the service which supported them to speak out and provide feedback.

The last time we inspected this service was on the 19 February 2016, we also carried out this inspection because concerns had been raised with us, but found that the concerns raised had been dealt with and the service was found to be offering a Good service to the people they supported.

The service had a 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 2008 and associated Regulations about how the service is run. The manager was also the provider of this small service.

Overall people were positive about the staff that supported them, but felt that the management team were disorganised. People told us they did not always feel safe, that staff were kind and the care they received was normally good, but the staff were very often late, did not always stay the for the full booked time and sometimes their visits were cancelled at short notice.

There was not enough staff to ensure that people were properly cared for and the manager did not always using safe recruitment practices when recruiting new staff.

Care plans were not always in place or had been updated when people’s needs had changed, so that staff supporting people did not know what their needs were or if there was any risks to that person’s health and wellbeing.

We could not be sure that people received their medicines safely, in some of the care plans we saw that people’s medication was not recorded properly and the medication administration records were not always completed properly. People were supported to maintain good health and had assistance to access to health care services when needed.

People were supported at mealtimes to access food and drink of their choice where needed, but because of poor time keeping people were sometimes being offered their meals at inappropriate times. This was because with staff arriving late for some visits and, on occasion, early for others people would be given their meals too close together.

The service was not always well led. Because of staff vacancies the normally office based manager and deputy manager had to cover care visits, this has had detrimental to their management roles and the service was not being managed effectively. Not all of the people and their relatives we spoke with had been made aware of how to make a complaint and had not been given a copy of the services’ complaints policy.

Staff received training and supervision and development opportunities. For example, staff were offered to undertake additional training and development courses to increase their understanding of needs of people using the service. However, because of the high turnover of staff recently the staff had mainly only attended the mandatory training, included safeguarding training, meaning that staff had received training to recognise the potential signs of abuse and what action to take to keep people safe.

The service considered peoples’ capacity using the Mental Capacity Act 2005 (MCA) as guidance. However, very few of the current staff had received this important training to ensure they have an understanding of the MCA and observed the key principles in their day to day work. Although people told us that staff did check that they were happy for them to undertake care tasks before they proceeded.

The service asked for feedback from the people who used the service by visiting them or over the phone regularly. They were in the process of sending out annual surveys to people and their relatives and the quality assurance policy stated that the survey results would be used to identify areas of the service that needed to be changed to improve the quality of the service.

The service had a 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 2008 and associated Regulations about how the service is run.

Overall the experiences of people were positive. People told us they felt safe, that staff were kind and the care they received was of good quality. However, there had been a period of time when there was not enough staff to cover all of the care calls to meet people’s assessed needs. This was because the manager, who is also the provider, had a personal injury and could not drive or carry out any personal care. They had been part of the care team. This lead to an incident when an untrained agency staff member was unable to complete their call because they were not trained to use the hoist at the person’s home. The agency worker was not used again and the existing staff pulled together while the manager found suitably trained staff to cover people’s calls while they recovered.

There were systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. Apart from the incident involving the manager’s injury and the use of an agency carer, the manager made sure there was enough staff at all times to meet people’s needs and employed new staff at the service using safe recruitment practices.

Assessments were undertaken to identify people’s support needs and care plans were developed outlining how these needs were to be met. We found that care plans were detailed which enabled staff to provide the individual care people needed. People told us they were involved in implementing the care plans and were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

The service considered peoples’ capacity using the Mental Capacity Act 2005 (MCA) as guidance. Staff were trained in understanding the MCA and observed the key principles in their day to day work checking with people that they were happy and consented for them to undertake care tasks before they proceeded.

People were supported at mealtimes to access food and drink of their choice where needed. The service had good leadership and direction from the manager. Staff were fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example, staff were offered to undertake additional training and development courses to increase their understanding of needs of people using the service.

The service had been registered four months at the time of this inspection and they were small enough to ask for feedback from the people who used the service weekly by visiting them or over the phone. It was planned to send annual surveys to people and their relatives and the quality assurance policy stated that the survey results would be used to identify areas of the service that needed to be changed to improve the quality of the service. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues. They told us that the provider responded to complaints quickly and normally to their satisfaction.