We undertook an announced inspection at My Little Angels Care Company Ltd, on 18 and 19 June 2018. This was the first inspection for the service under their current registration. My Little Angels Care Company Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection, the service told us they were providing care for 59 people. CQC only inspect the service received by people provided with personal care; as well as help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
There was a registered manager in post. 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 knew the registered manager personally. They had either had their initial assessment completed by the registered manager, had spoken to the registered manager in the office, or had received support from them during a care visit.
Prior to the inspection we spoke with nineteen people who use the service. Where it was not possible to speak with the person, we spoke with their next of kin. We received positive feedback about the service and people told us that they liked the care staff. Comments included, “They are kind and caring.” Also, “I like them very much, they just care so much, we find them very supportive.”
People told us the care staff were respectful of their home and belongings. Some people received support with domestic tasks such as cleaning. They told us staff completed these tasks to a good standard.
Staff understood their responsibilities to identify and report any safeguarding concerns. People told us the staff helped them to feel safe. Relatives told us they had no concerns regarding their family members safety while being supported by the care staff.
Some people told us that they knew the service had been experiencing difficulties in recruiting new staff. One person said, “They seem to have lost a lot of staff, I’m not sure why.” Another person explained, “There has been a lot of staff changes recently.”
The registered manager told us that there had been some recruitment challenges over a six-month period prior to the inspection. We saw that the registered manager and trainee manager attended care calls during the inspection. The registered manager told us new staff had been recruited, however they were awaiting employment checks and completion of their notice period before starting.
Staff received face to face and online training. Changes had recently been made to the staff induction. The registered manager explained that this was to improve the retention of new staff.
There were regular spot checks completed by the training manager. The training manager explained that they complete care visits alongside the care staff, so they can observe their practice. When training needs were identified during the spot checks, the training manager then arranged this support with the member of care staff to address this.
The registered manager sent feedback forms to people on an annual basis. People were asked to let the service know of any areas where improvements could be made. Almost all feedback received was positive. Where suggestions were made for improvements, these were areas such as identifying a training need for individual staff members, rather than relating to the service overall. We saw evidence that action was taken in response to each suggestion or concern raised in the feedback forms.
Staff achievements were rewarded and when positive feedback was received, staff were given a certificate of commendation. We saw one staff member receive their certificate and a bunch of flowers to thank them following feedback received from a person’s family.
Care plans were written using dignified language and contained person centred details. We saw people’s preferences were documented, such as what they would like staff to prepare them for breakfast. People’s preferred routines were also detailed in the care plans, such as where they liked staff to accompany them on a social visit. People and their relatives were involved in reviewing the care plans, to ensure the information remained up to date.
The service had identified that some aspects of the care plans could be improved to include more information about how staff can support the person’s wellbeing. The trainee manager was due to explore this further as part of their leadership qualification.
Records for people’s food and drink intake were not always completed to evidence how much the person had eaten or drank. We discussed with the registered manager that they should consider if the recording format was suitable for the nature of the service. The registered manager and trainee manager discussed different ways this information could be captured.
Daily care records included information about the tasks that staff had undertaken as part of their visit, but also records about social interactions and the person’s wellbeing.