Archived: Cherished Care Services

Cherished Care Services is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of our inspection 50 people were supported.

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

Improvements were needed to ensure staff completed required trained and the provider had effective oversight in this area. People, relatives and staff also shared concerns over training staff completed and how this was reviewed.

Policies were not always up to date. This meant staff did not always have information to ensure they understood responsibilities placed on themselves and the provider during their employment.

People told us they felt safe with the support provided by staff. Overall care calls took place at expected times and senior staff at the office were always available if issues occurred. However, high staff turnover levels left some people concerned about receiving inconsistent care from staff who did not fully know their care needs.

Medicines were administered safety, however, some update of information within care plans was required.

Care plans provided step by step guide on how people wished to receive their care call, which overall reflected feedback from people and relatives. We found other information within care plans required further review to ensure dated records within plans were up to date.

People were involved in care planning. Care call reviews were completed by senior staff with people to assess the quality of care being given. People told us they were happy with the approach from care staff who were respectful with how they provided care. 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.

We received a mixed response from staff over the culture of the service. Some staff told us they did not feel valued by the provider, nor had opportunities for regular 1-1 discussions in supervisions and team meetings. Other staff told us they enjoyed working for Cherished Care Services and felt supported in their role. We saw some evidence supervisions took place with staff, including spot checks to assess how they provided care to people. However, regular meetings with staff did not occur.

The registered manager and chief-executive demonstrated an approach they wished to make positive changes and improvements. Throughout the inspection they provided evidence of improvements they were completing, which included staff engagement.

The registered manager carried out audits and checks, this included reviewing accidents/incidents and events that occurred across the service.

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 5 March 2018).

Why we inspected

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

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We have identified breaches in relation to appropriate support, training and supervision with staff, as well as in relation to the provider policies and oversight of training requirements and training records of staff.

Please see the action we have told the provider to take at the end of this report.

We also made recommendations on staff engagement and the provider to review people’s care plans in relation to medicines, care plan review dates, and ensuring sufficient details about peoples preferences and dietary needs is incorporated into care plans.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Cherished Care Services is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of the inspection the registered provider was providing support to 14 people.

This service is a domiciliary care agency. It provides a service to older adults, and to younger adults in their own houses and flats in the community. 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 the inspection 14 people were receiving personal care.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider had a variety of different systems and processes in place to assess and monitor the quality and standard of the care being provided. This meant that people were receiving safe, compassionate and effective care. Such systems included regular ‘spot checks’, care plan and medication audits, medication competency assessments as well as quality questionnaires.

We reviewed a number of care records during the inspection and found that records were organised, well maintained, regularly reviewed and updated in order to minimise risk Care plans were person centred and provided detailed information in relation to a person’s wishes, choices and preferences.

Medication management systems were safely and effectively managed. People who were receiving medication support had the necessary medication care plans and risk assessments in place and staff were familiar with specific health needs of people who were being supported. Staff had received the necessary medication training and there was an up to medication policy in place.

We found the area of ‘recruitment’ was safely and effectively managed. This meant that all staff who were working for the registered provider had suitable and sufficient references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed to care and support people are suitable to work within a health and social care setting. This enables the registered manager to assess level of suitability for working with vulnerable adults.

We reviewed ‘safeguarding’ processes and procedures which the registered provider had in place. We found that people were protected from avoidable harm and risk of abuse. Staff were familiar with the area of safeguarding and knew how to report any concerns.

Staff were fully supported in their roles through supervisions, annual appraisals and regular team meetings. Training, learning and development was encouraged by the registered provider and staff were provided with the necessary skills to fulfil their roles.

Accidents and incidents were being recorded, monitored and trends were being analysed. All staff we spoke with knew how to record any accidents/incidents and were aware of the serious incident policy and procedure.

We saw evidence during the inspection that the day to day support needs of people was being safely managed and people were receiving the appropriate care from health care professionals. Appropriate referrals were taking place and the relevant guidance and advice which was provided by professionals was being followed accordingly.

People were provided with a ‘Service user’ guide from the outset. The guide clearly outlined what people should expect from the registered provider and people were informed about the complaints process and procedure.

The registered manager was aware of their responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with the CQC’s statutory notifications procedures.

We reviewed a range of different policies and procedures which the registered provider had in in place. Policies we reviewed included confidentiality, safeguarding adults, equality and diversity, whistleblowing, serious incidents, infection prevention control and medication administration policies. Policies and procedures were available to all staff and staff were able to discuss specific policies and procedures with us during the inspection.