Absolute Care - Westbourne

Updated 31 October 2018

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.

The inspection took place on 5, 8 and 9 October 2018, and included visits and phone calls to people who use the service. We told the service one day before our visit that we would be coming to ensure the people we needed to talk to would be available. This inspection was conducted by one Care Quality Commission inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service; this included incidents they had notified us about. We also looked at the information we had received from notifications made to us by the service. A notification is information about important events which the provider is required to tell us about by law. Additionally, we contacted four Health Care professionals to obtain their views of the service.

During the inspection we visited four people in their homes and spoke with another ten people on the telephone who used the service. We spoke with three members of office staff and three members of care staff. We checked four people’s care and medicine records in the office and with their permission, the records kept in their home when we visited them. We also saw records about how the service was managed. These included four staff recruitment and monitoring records, staff rotas, training records, audits and quality assurance records and complaints as well as a range of the provider’s policies and procedures.

Updated 31 October 2018

Absolute Care - Westbourne is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. The inspection took place on 5, 8 and 9 October 2018 and was announced. We gave the provider one working days’ notice to ensure people and staff we needed to speak with were available. At the time of the inspection visit Absolute Care provided care and support for 36 people living in their own homes. All of the care packages were privately funded.

Not everyone using Absolute Care receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

Our previous inspection of the service carried out in September 2017, identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. These included people’s rights not being protected because staff had not consistently acted in accordance with the mental Capacity Act 2005, people not always being protected against the risks associated with the unsafe management and use of medicines. Effective systems and processes had not been established to assess and monitor the quality and safety of the service and checks had not been consistently carried out to ensure that staff were suitable to work with vulnerable people. At this inspection we found the provider had made many improvements to ensure all of the regulations were met. These improvements included a total revision of the processes used to recruit and train staff, specific training for all staff around The Mental Capacity Act 2005 and the management and use of medicines and a robust programme of quality monitoring systems and process that ensured the management team had full oversight of the service and had effective governance processes in place.

People gave positive views and were very satisfied with the quality of service they received from Absolute Care. People told us, “I would recommend them, they have been very good” and “On the whole they are pretty good, I can’t fault them.”

Staff spoke knowledgeably about maintaining people’s safety and knew how to identify and raise concerns regarding any potential abuse. Every person we spoke with told us they felt safe with all the care staff employed by Absolute Care. They said care staff treated them with respect, and were friendly, kind and gentle when supporting them.

Staff told us they felt well supported in their roles and enjoyed their work. One staff member told us, “I received really good support all through my induction. I felt very well prepared when I started to provide care to people on my own. The shadowing process worked very well.” Staff expressed confidence in the management team and said there was an effective management structure in place that ensured they were listened to and fully supported in all areas of their roles.

People and staff spoke of an open, honest and caring culture that was available for them and said there was always someone they could speak to at any time, if they needed further advice and guidance. Staff were consistently well supported by a clear system of supervision, observations, spot checks and annual appraisals.

There was a robust recruitment and induction process for staff which ensured people were cared and supported by staff who had been safely recruited.

People told us staff were well trained and knowledgeable and delivered their care and support in the way they preferred. Training was delivered regularly through the use of independent training companies and electronic systems. Staff said they found the training useful and thorough.

The provider had a strong focus on the use of technology and how its’ use could improve people’s experience of the care and support they received. The use of technology supported the provider to plan, deliver and monitor people’s care. This led to people receiving safe, effective and responsive care and support.

Medicines were managed safely. There were clear medicine management systems in place which ensured care staff were provided with accurate, up to date information in order to support and administer medicines to people.

People's rights were protected because staff and management had received appropriate training and had a good working knowledge of the Mental Capacity Act 2005. People’s consent to their care had been sought in line with legislation and guidance.

People told us they received good, personalised care and support from a regular staff team who knew them well. People and staff received weekly rotas that showed which member of care staff was delivering the care and at what time. People and care staff told us visit times gave care staff enough time to complete their role and travel times between visits were realistic.

There were systems in place to protect people and the security of their home when they received their care and support. Care staff wore uniforms and carried identification to ensure people knew who they were.

People and staff told us communication within the company was good. Staff spoke positively of the different communication systems in place which they found, “Very useful.” People confirmed they were kept informed if care staff were running a little late. One person told us, “If they are ever running a bit late, I get a call from the girls at the office to let me now. It works well.”

There were quality assurance systems and a range of policies and procedures to enable people to receive safe, effective care and support in their own homes. People’s views on the service were regularly sought. These views were then reviewed and analysed to monitor the level of service provided and drive forward improvement.

People knew how and who to complain to if they needed to. The provider had a complaints policy which gave people clear guidance and timescales to follow if they needed to complain. Complaints had been investigated and acted upon in accordance with the providers’ complaints policy.