Caritas Care Solutions

Caritas Care Solutions is a domiciliary care service. This provides personal care to people in their own homes. At the time of the inspection 69 people were using this service.

The Care Quality Commission (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

This was a targeted inspection which considered staffing. Staff were safely recruited and there was enough staff to meet people’s needs.

People and relatives were happy with the service they received from Caritas Care Solutions. They said care staff attended on time and knew their roles well.

People felt safe when receiving support from staff and spoke of the caring nature of staff.

Some staff were concerned about travel time and the consistency in allocations of care calls, so that people received care from people who knew them.

Some staff raised concerns about their employment contracts. We shared their concerns with other agencies and signposted staff.

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 4 October 2018).

Why we inspected

We undertook this targeted inspection in relation to a specific concern we had about staffing arrangements at the service. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

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

This service is a domiciliary care agency. It provides the regulated activity personal care and treatment of disease, disorder or injury. This includes support with activities such as washing and dressing, the provision of meals and the provider also had individual arrangements in place to support people with their medicines where necessary. It provides a service to older people, younger adults, people with sensory impairment, physical disability, dementia and learning disabilities or autistic spectrum disorder.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of this inspection the provider was not supporting any people with learning disabilities.

Not everyone who used Caritas Care Solutions Limited received a regulated activity. CQC only inspects the service being received by people provided with 'personal care' or 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 this inspection 29 people were receiving a service, and 28 of those received a regulated activity.

The registered manager had been in post since 7 September 2016. 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.

Staff were fully supported in their role. The registered manager had ensured staff received regular supervisions and appraisals.

Manager's audits used to maintain and improve standards in the home were always dated and regularly completed to drive improvements across the service. Action plans were in place and had been followed up to address the areas identified as requiring improvements to be made.

Records had been updated and regularly reviewed so that information for staff was current and reflective of people’s needs. Staff had access to records via their handheld devices when providing care to people in their homes. In addition, paper documentation was available should they need to check or reference anything.

Quality assurance checks had identified and driven improvements across the service since our last inspection.

Staff had received additional training and the registered manager had regularly checked staff knowledge and understanding of the Mental Capacity Act.

People told us that staff arrived on time. If staff were running late people received a call from the office staff to inform them. All the people and their relatives we spoke with were happy with the service and felt staff knew their needs well.

Staff could describe the different types of potential abuse and knew how to report any incidents of abuse or potential abuse. The provider had ensured that notifications were sent to CQC in line with their registration requirements.

Policies were in place to support the safe administration, storage and disposal of medicines. Where people received support with their medicines, these were administered and recorded appropriately and regular spot checks were completed.

Recruitment procedures included appropriate checks to ensure prospective staff were of suitable character to work in a care setting and had the right to work in the UK.

Training records showed that staff had completed induction training and shadowed an experienced member of staff to observe and learn about the duties expected of them before being approved as competent to work alone. Refresher training was completed and scheduled for all staff.

People and their relatives told us that staff were kind, conscientious and caring towards them. Some staff had listened to people’s aspirations and supported them to achieve their goals.

A complaints policy was in place and records showed the provider had managed issues and concerns in line with their company policy.

The registered manager visited people and their relatives to obtain their feedback about the service. In addition, annual surveys were sent for people to complete. The provider was keen to ensure everyone’s views were taken on board so their experiences could be enhanced where it was possible.

The service is registered to provide the regulated activity personal care and treatment of disease, disorder or injury. This includes support with activities such as washing and dressing, the provision of meals and the administration of medication for people living in their own home.

On the day of the inspection 21 people were receiving assistance with personal care. The agency office is situated in Melton, close to North Ferriby, in the East Riding of Yorkshire. Car parking is available for people who wish to visit the office by car.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a registered manager 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.

Staff were not fully supported in their role. We found the registered provider had failed to follow their own policy and procedure to ensure all staff received regular supervisions and an annual appraisal.

Manager’s audits used to maintain and improve standards in the home were not always dated or completed regularly. Actions were not noted in relation to accidents and incidents. Staff did not have access to up to date information for people because care records we looked at were out of date and important information had not been transferred to the appropriate areas within care plans. This meant reviews of people’s records were ineffective to ensure staff could provide care and support appropriate to people’s individual needs. Quality assurance checks completed by the registered provider were ineffective because they had failed to identify and address the concerns we found during our inspection.

Some staff did not fully understand the MCA and DoLS, we discussed this with the manager who agreed to arrange further training and regular competency checks so that additional support could be given to those that needed it.

Staff felt they had enough travel time in between calls. We saw there were sufficient numbers of staff employed to meet people's individual needs.

We found that people were protected from the risk of harm or abuse because the registered provider had effective systems in place to manage any safeguarding concerns. Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. However, on one occasion information had not been reported to CQC. This was received after the inspection.

Where people received support with their medicines, these were administered and recorded appropriately and regular spot checks were completed. However, the one medicines audit that had been completed was not dated. This meant we could not evidence that systems and processes were in place to identify and learn from errors.

Training records showed that staff had completed induction training and had a period of shadowing during their initial 12 weeks of employment. Refresher training was completed regularly. Staff told us that they felt the induction period was sufficient for them to provide a good level of care and support.

People told us that they were happy with the level of service provided and that staff was very kind and caring to them. During our observations we could see that staff knew people well and genuinely cared for them.

There was a complaints policy and procedure and this had been made available to people who received a service and their relatives. People we spoke with told us they were satisfied with how their complaint had been resolved.

There were systems in place to seek feedback from people who received a service and we saw that most of this feedback was positive. However, the relatives we spoke with could not recall being asked their opinions about the service or being asked to complete a survey. This was something the registered manager was in the process of improving.

The registered provider was in breach of two regulations under the Health and Social Care Act. You can see what action we told the provider to take at the back of the full version of the report.