Candid Health & Social Care Ltd

People’s experience of using this service and what we found

We found a breach of a regulation relating to good governance. Quality assurances systems were not effectively used to monitor the quality of care. For example, the provider did not ensure records of staff meetings and supervisions were maintained. In addition, quality assurance records were not consistently kept such as contact with people using the service and spot checks undertaken to monitor the quality of care provided.

Staff did not receive periodic supervisions and an annual appraisal of their performance in line with the provider’s policy and procedures. The provider failed to note that all learning and development and required training completed should be monitored and appropriate action taken quickly when training requirements are not being met.

Despite these findings, people and their relatives were happy with the care provided. Their comments included, “I am very happy with my carers” and “[Staff] are pretty good with [person]. They are all caring [care staff].”

People received care when needed. People were cared for by staff who were recruited safely. Staff underwent an induction before they started providing care.

People were protected from the risk of avoidable harm. One relative told us, “I feel [family member] is safe when they go out. [Person is always happy with the [staff].” Staff understood their responsibility to protect people from harm and abuse and to whistle blow concerns. Risk assessments were undertaken and support plans provided guidance to ensure staff were able to provide care safely. People were supported to take their medicines when required. Staff understood and followed infection control procedures to reduce the risk of contamination.

Staff told us they felt well supported in their roles. The manager told us the organisation was undergoing management change and had plans in place to formalise supervisions and any additional support provided to staff. People received the support they required to maintain good health and their well-being.

People received care from regular staff. This enabled them to develop positive and meaningful caring relationships. Staff upheld people’s dignity and privacy. People told us they consented to the care delivered to them. People received support to maintain their independence and to make decisions and choices about their daily living.

People’s care and support needs were met. Reviews were undertaken and updates made to care and support plans to reflect changes to each person’s needs. People received support to access health services when needed. People and their relatives knew how to make a complaint if they were unhappy with any aspect of their care.

People, their relatives and staff were happy with the running of the service. They felt their views were considered. The manager understood their responsibility to promote a culture of learning when things went wrong to minimise the risk of incidents happening again. The manager worked in partnership with other agencies and health and social care professionals to ensure people were supported as appropriate to meet their needs.

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.

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

Rating at last inspection

The last rating for this service was good (published 18 December 2018) at this inspection, the rating has deteriorated to Requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using Candid Health Care (CHC) Ltd receives a 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. At the time of our inspection 17 people were receiving the regulated activity of personal care.

At the last inspection in June 2016 the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager in post but they were not present during our inspection. 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 service has a registered manager in place and a team leader who has overall day to day responsibility for the service.

Risk assessments were completed for people using the service and staff were aware of how to manage the risks. Staff had good knowledge of safeguarding, including how to report incidents of abuse. This ensured there were systems in place for identifying and managing concerns and risks to people.

The service had enough staff. There were good recruitment processes in place to ensure staff were checked and were suitable to provide care and support. There were arrangements to ensure staff had induction, training, supervision and annual appraisal.

The service had systems for monitoring incidents, accidents and complaints. People and relatives were confident that their concerns and complaints were investigated and lessons learnt by the registered manager to improve the service.

Medicines were well managed through the availability of trained staff and regular auditing systems. When required, staff prompted or administered medicines.

Care plans were personalised. People and relatives were involved in the review of the plans. 'How to communicate' with people was included in care plans and was part of discussions in staff meetings.

The provider was compliant with the principles of the Mental Capacity Act 2005 (MCA). Staff encouraged and supported people to make decisions about their care. They treated people with respect and ensured people's privacy and dignity was maintained.

The provider worked with health professionals. People's medical needs were included in their care files and staff knew the contact details of healthcare professionals.

Where required, staff supported people with their meals. People's dietary needs were recorded in their care files.

Various auditing and quality monitoring systems were in place to ensure the service was managed effectively.

Staff were provided with personal protective equipment such as gloves, aprons and antibacterial gels. They had training and knowledge of infection control.

Candid Healthcare provides personal care to people living in the London borough of Havering. On the day of our visit there were 28 people using the service.

At the time of our inspection a registered manager was in place. 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.

People told us that they trusted staff who looked after them and that most visits were at the scheduled times. Where required people were assisted to take their medicines safely.

Staff had attended safeguarding training and were able to demonstrate how they would respond to any allegations or witnessed abuse by notifying the appropriate authorities.

Risks were assessed and clear steps to take to mitigate identified risks were recorded to enable staff to care for people safely.

People told us they were supported by regular staff and that none of their visits had been missed. Staff were matched to people’s needs and suitable arrangements were made to cover sickness and absences.

There were robust recruitment systems in place to ensure that staff only commenced after appropriate checks had been completed. Staff were supported by means of annual appraisals and regular supervisions.

Staff sought consent before care was delivered. They had completed training relating to the Mental Capacity Act (2005) and were aware of their roles and responsibilities to ensure the people’s voice was heard.

People told us that their privacy and dignity was respected. They were aware of how to make a complaint but told us they did not have to complain often. When they did complain the complaint was resolved quickly.

Care plans although sometimes brief were based on people’s preferences and included their past history and present likes and dislikes. We made a recommendation to seek further guidance on record keeping.

People, their relatives and staff thought the service was well led and that staff and, management were approachable. There were systems in place to monitor the quality of care delivered. However we made a recommendation to seek guidance on effective communication.