Caretakers SW Limited

Caretakers SW Limited is a domiciliary care agency that was providing personal care to people in their homes in Paignton and Torquay. At the time of our inspection 96 people were using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Personal care is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided.

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

Since the previous inspection, the service had made improvements to record keeping and travel time between visits.

People felt safe and comfortable when staff visited them in their home. People were kept safe as potential risks had been assessed and managed. There were enough staff to complete planned visits.

People’s needs were met by staff who had received regular training and support. 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 received personalised care from staff who knew them well. People were treated with kindness and compassion by staff. People were involved in making decisions about their care and supported to maintain their independence. Care plans contained up-to-date information about each person’s needs and preferences.

People and their relatives were asked for their views about the service. The most recent feedback results showed that people were happy with the service they were receiving.

There were effective quality assurance and governance systems in place to assess, monitor and improve the quality and safety of the service.

The registered manager was committed to improving care where possible and had developed effective working relationships with other professionals and agencies. The service had been nominated for The Outstanding Care Awards for Devon and Cornwall 2019 in the categories of ‘domiciliary provider of the year’.

The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.

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

Rating at last inspection and update

The last rating for this service was requires improvement (report published 19 July 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. We received some concerns before the inspection relating to staffing, staff training, and people’s needs not being met. We examined these risks as part of the inspection. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, Effective, and Responsive sections of this full report.

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.

Domiciliary care services provide personal care to people living in their own houses and flats in the community. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care. Caretakers (SW) Limited is registered to provide personal care to older and younger people and people who have learning disabilities. Some people had additional services offered by the provider including domestic, recreational and companionship help.

This inspection took place on the 9, 10, 22 May 2018 and 11 June 2018. 72 hours’ notice was given as we needed to be sure the registered manager would be available when we visited the agency offices. This was the first inspection of the service since it had moved location.

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.

People’s support plans required developing to be more individualised and describe how they liked their needs met and their individual routines. Care plans needed to be more comprehensive to include the role of staff in medicine administration and where health needs such as diabetes had been identified. End of life care plans and people’s end of life wishes needed to be incorporated into care records. Risk assessments required more detail to reflect staffs role in mitigating risks in relation to skin care. The provider’s governance and quality assurance systems needed improvement to ensure issues such as this could be identified and action could be taken to improve.

People and relatives told us they were well cared for by staff. People had regular reviews to ensure the service provided to them changed as they did. No one had any complaints about their care. Feedback from all people and relatives was very positive. The management team were open and approachable. The provider and registered manager listened to feedback and reflected on how the service could be further improved. Some people and staff told us communication could be improved for example when there were changes to rota’s and timings of visits. Staff told us the lack of travel time between visits was an area for improvement.

People were protected from harm and discrimination. People’s human rights were protected because the code of practice in relation to the Mental Capacity Act 2005 (MCA) was followed. Staff told us they always asked people for consent and explained what they were doing. However, people’s and ability to consent was not incorporated in to their care plans. People’s nutritional needs were met because staff followed people’s support plans to make sure people were eating and drinking enough and potential risks were known.

People were treated equally and fairly. Staff adapted their communication methods dependent upon people’s needs, for example simple questions where people had cognitive needs and loud clear speech if people had hearing impairment. Verbal information and explanations about care were given to people with cognitive difficulties and was available in a different format if people required information.

People were supported by staff who were compassionate, kind and caring. All staff demonstrated kindness for people through their conversations and interactions. People were supported by a consistent staff group who knew them well. People’s privacy and dignity was promoted. As far as possible, people were actively involved in making choices and decisions about how they wanted to live their lives. People were protected from abuse because staff understood what action to take if they were concerned someone was being abused or mistreated.

Risks associated with people’s care and living environment were effectively managed by staff to ensure their freedom was promoted. This was because staff knew people well. People’s independence was encouraged and staff helped people feel valued by engaging in everyday tasks where they were able to.

The provider and management team wanted to ensure the right staff were employed, so recruitment practices were safe and ensured that checks had been undertaken. Staff underwent a thorough induction and ongoing training to meet people’s needs effectively. People’s medicines were administered safely but the care plans relating to medicine administration and the role of staff in prompting or supporting a person required development.

People received care from staff who had undertaken training to be able to meet their unique needs. Some staff were “champions” in specific areas and staff we spoke with told us the training was good and they felt skilled and confident. People were supported to access health care professionals to maintain their health and wellbeing.

People were protected from infection by staff that were trained in this area and used gloves and aprons where required. People told us their homes were left tidy and clean.

People we spoke with did not have any complaints and were confident raising minor concerns with the office staff.

We found one breach of our regulations in relation to care plans and people's records.

You can see what action we told the provider to take at the back of the full version of the report.