Care Staff Services Ltd

Updated 4 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an expert by experience. An Expert by Experience (EXE) is a person who has personal experience of using or caring for someone who uses this type of care service. They made telephone calls to discuss people’s experiences of the care and support received.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection site visit activity started on 09 July 2019 and ended on 11 July 2019. We visited the office location on all three days to see the registered manager and office staff; to review care records; policies and procedures and records relating to the management of the service. The EXE made telephone calls to people on the 9 and 10 July 2019.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

Throughout the inspection we gave the provider and registered manager opportunities to tell us what improvements they had made since our last visit. We looked at feedback given directly to the service by an adult social care professional and included this in the report.

We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with five members of staff including the registered manager. We reviewed a range of records. This included five people’s care records, two staff files in relation to recruitment and staff supervision, training data, policies and procedures and a variety of records relating to the management of the service.

After our visit we received feedback from another adult social care professional which was included in this report.

Updated 4 September 2019

About the service:

Care Staff Services Ltd is registered to provide personal care to people living in their own homes. At the time of the inspection 36 people were being supported with personal care. The main office is based in Burnham.

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 and relatives felt safe from harm and were aware of what to do if they felt unsafe. Staff were aware of their responsibilities to protect people from harm and had attended the relevant training. Assessments of people’s care and support needs identified risks to people’s welfare and safety and plans were put in place to manage those risks. There were enough staff to provide care and support to people. Medicines were administered safely, and staff followed infection control practices to protect people from infection. Staff recruitment practices in place ensured people were cared for by staff who were aware of good practice and references were sought. However, job applications were not always fully completed and gaps in employment were not always explained. We have made a recommendation about this in the report.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. People and relatives said consent was sought before care was delivered. The service acted in accordance with the Mental Capacity Act 2005 where people were not able to make specific decisions.

People and relatives spoke positively about the caring nature of staff. A person when commenting about their care worker said, "She is very helpful, calm, friendly, helpful and will go out of the way to help.” A relative when commenting about a care worker said, “She is very friendly and kind, helpful and very good to [name of relative]. She is so caring.” Staff had a good understanding of people’s care needs, family histories and care records showed staff were instructed to deliver care in a person-centred way.

People and relatives felt staff were skilled and experienced to look after them. Staff received appropriate induction, training and supervision. People’s nutrition and hydration needs were met. The service worked with health and social care professionals to ensure people’s health needs were met.

People and relatives said the service assessed their needs before their packages of care started. This ensured the service developed plans of care that was based on what people said they wanted. People and relatives said they were involved in decisions about their care and meetings to review and discuss any changes in their care happened. The service was compliant with the Accessible Information Standard by making sure the communication needs for people with disabilities and sensory impairment were met. People knew how to raise concerns and felt confident to do this. We found complaints were responded to appropriately.

People and relatives felt the service was well-led, staff spoke positively about the culture of the service and said management were approachable. Quality assurance systems in place was improved to enable the service to identify where quality and safety were being compromised. Appropriate action was taken to address any concerns identified however, further work was required to clearly identify themes, trends and lessons learnt. We have made a recommendation about this in the report.

Rating at last inspection and update: The last rating for this service was requires improvement (published 4 May 2018). 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.

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.

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