Archived: Sanctuary Home Care Ltd - Rye

Sanctuary Home Care Ltd - Rye is a domiciliary care service providing personal care to 13 people older people at the time of the inspection. This service provides care and support to people living in specialist 'extra care' housing. People using the service lived in a block of 55 flats within one building called St Bartholomew’s in Rye. Not all people living in the flats received support from Sanctuary Home Care Ltd – Rye. Some people were supported by other domiciliary care services and others did not have care and support needs.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People told us they loved the staff and support from the service. One person told us, “They are good, I would recommend them.” Another said, “It’s nice living here, the staff and the atmosphere.”

People received care that was tailored to their needs. Activities were based around people’s backgrounds, interests and passions and people were encouraged to take part. Staff had considered loneliness and encouraged the making and maintenance of relationships.

People felt safe and were supported by staff who understood safeguarding, and how to report any concerns. Risks to people’s safety and wellbeing were considered and planned for. There were enough staff available to meet people’s needs and planned care visits. Medicines were managed safely. Infection control was well managed. When things went wrong, lessons were learnt and staff worked with other professionals to ensure the risk of reoccurrence was reduced.

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.

People’s needs and choices were assessed before they received support from the service. Current guidance and recognised tools were used to assess people’s needs. Staff were supported with induction, training and supervision to ensure they had the right skills to support people. People were supported to eat and drink, as needed. People were encouraged to live healthy lives and access health care support.

People were treated with kindness and compassion. People’s views about their support were important and they were encouraged to express these. People’s privacy and dignity were respected. People were supported in a way that encouraged their independence.

There was a positive, person centred culture within the service. People’s views of the service were sought and acted upon. Staff felt well supported by the manager and their efforts were recognised, such as through employee of the month. Staff worked in partnership with other professionals. The quality assurance framework supported the development of the service, with the identification of areas for improvement.

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 23 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Sanctuary Home Care Limited provides personal care services to people who live at St Bartholomew Court housing service (sheltered housing scheme). St Bartholomew Court was opened last year and is a purpose built complex where people live in individual flats with shared facilities which include, a hair salon, a lounge and dining area and a kitchen that provided meals for people who wish to purchase them. The service’s office is located within the building. At the time of our inspection 13 people were receiving personal care services from the staff team who worked there. Other people living on the complex received personal care from other local domiciliary care agencies and others required no support.

There was a registered manager employed at 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 2008 and associated Regulations about how the service is run.

People told us they received their medicines regularly and staff had been trained to administer medicines. However, the provider’s policy and procedures were not fully in line with best practise. The registered manager took action to address this. The staff manually transferred the instructions for administering people’s medicines onto the Sanctuary Medicines Administration Record (MAR) as they said the ones provided by the pharmacy did not meet the needs of the people receiving support. This could increase the risk of errors occurring. However, no recent errors had happened.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The service was supporting people to make decisions about their health and wellbeing. Staff had knowledge about the MCA and how to implement it on a daily basis. Formal mental capacity assessments had not been completed to demonstrate when people could make decisions for themselves and when they may need support. We have made a recommendation to the provider about this.

People received support in line with their assessed personal care needs. Systems were in place to manage risks to people. In some cases further details would enhance the risk assessments so that staff had full written guidance about what action to take to reduce risks. Staff were able to explain what action they took to keep risks to a minimum.

There were systems in place to monitor incidents and accidents and to take appropriate action. There was a business continuity plan in the case of an emergency, such as fire, flood or the breakdown of the technical systems.

The registered manager regularly carried out checks to identify any shortfalls and ensure consistent, high quality, personalised care. People and their relatives had been surveyed to ask their opinions on the service, but staff and other stakeholders such as people's GPs had not been asked. This is an area for improvement.

Safeguarding procedures were in place to keep people safe from harm. People felt safe using the service; and if they had any concerns, they were confident these would be addressed quickly by the registered manager. The staff had been trained to understand their responsibility to recognise and report safeguarding concerns and to use the whistle blowing procedures.

People were protected by robust recruitment procedures and new staff had induction training which included shadowing experienced staff, until they were competent to work on their own. Staff received core training and specialist training, so they had the skills and knowledge to meet people’s needs. They fully understood their roles and responsibilities as well as the values of the service.

People told us that they had never experienced a missed call as there were always staff available including cover for sickness and annual leave. They told us that they received a service from regular staff, who arrived on time and stayed the duration of the call. People said the service was flexible and provided additional calls if they needed extra help.

The service operated an 'out of hours' system for people or staff to ring if they needed additional assistance during evenings and weekends.

People told us that they were very happy with the service provided. Staff knew people’s individual needs and how to meet them. People and their relatives were fully involved in the assessment and planning their care. The care plans contained the information needed to support people in the way they preferred and suited them best. Some of the guidance in the care plans was not detailed. This is an area for improvement.

People’s care plans had been reviewed and staff were aware of any changes .Staff said the communication between them and the office made sure that they were up to date with people’s changing needs.

Staff supported people to prepare meals to make sure they had a range of nutritious food and drink. The service made appropriate referrals and worked jointly with health care professionals, such as community nurses, doctors and specialist services to ensure that people received the support they needed.

Staff were caring and treated people with dignity and respect. They were kind, compassionate and polite. Staff often took people out during the day to attend various activities in the local community. The activities varied depending on what the person liked and enjoyed.

People felt confident in complaining, but did not have any concerns. People had opportunities to provide feedback about the service informally and formally. The feedback received had been positive.

The culture within the service was transparent, personalised and open. People said they felt comfortable talking to the provider about their concerns and ideas for improvements. The provider and registered manager looked at new ways of working to continuously improve the service.

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