This inspection took place on 31 October and 2 November 2018. We gave the provider 24 hours’ notice as the registered manager is often out of the office and we needed to ensure they would be available during the inspection.SarJoeMc is a domiciliary care agency, also known as Apollo Care Liverpool. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults living in Liverpool and Knowsley. Services ranged from weekly calls, multiple calls daily and sleep in support. Short term rehabilitation support was also provided which was arranged through the local authority.
Not everyone using this service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. SarjoeMc were supporting 42 people in total, but only 26 of these people received personal care. This inspection only looked at the support provided to people who received a regulated activity.
SarJoeMc registered with the Care Quality Commission (CQC) in July 2017 and this was the service's first inspection. The registered provider had changed their address in May 2018 and submitted an incomplete application to change the location address, which was rejected. As a result, we found the location address was not correct at the time of this inspection in October 2018. The registered provider told us they were in the process of submitting another application to ensure the location address was updated.
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. Feedback regarding the management of the service was very positive.
People told us the support they received from care staff kept them safe and relatives we spoke with agreed. Staff were knowledgeable about safeguarding procedures and how to raise any concerns they had. Staff had completed risk assessments to assess and monitor people’s health and safety and actions were taken to mitigate the risks.
There were sufficient numbers of staff recruited to ensure people’s needs could be met. However, not all safe recruitment checks were clearly recorded as references were not always from the most relevant people and staff employment history was not always robustly recorded. We made a recommendation about this in the main body of the report.
When people required support with medicines, we found that systems were in place to help ensure this was managed safely.
Staff liaised with other health and social care professionals to ensure that people received the support they needed.
Staff were supported through a comprehensive induction when they started in post. Staff told us they received regular supervisions and that they could go to the registered manager at any time if they had any concerns they needed to discuss. Staff had completed training to enable them to support people safely.
The service was not supporting anybody who had been assessed as lacking capacity to consent to their care and treatment. The registered manager told us they would liaise with the local authority regarding Court of Protection if this was required.
People told us staff were kind and caring and treated them with respect. They also told us staff protected their dignity and privacy. Records relating to the care people received were stored securely in the office to ensure people’s confidential information was protected in line with the Data Protection Act.
Care plans guided staff to provide support in ways that encouraged people to be as independent as they could be.
People were supported by the service to communicate effectively, ensure they had their views heard and were provided with information in ways they could understand.
Care plans were very detailed regarding the needs and preferences of the people supported. They clearly reflected what support people wanted and how they wanted it to be provided and their preferred routines. This helped staff get to know people as individuals and provide support based on their preferences.
A system was in place to manage any complaints, although none had been received. People felt any concerns they raised would be taken seriously by the registered manager and addressed.
Staff worked in conjunction with district nurses to support people at the end of their lives. Records showed that staff had recently completed palliative care training to help ensure they could support people effectively at these times.
The service was meeting the Accessible Information Standard (AIS) as steps had been taken to meet the needs of people with sensory loss.
Systems were in place to gather feedback from people and assess the quality and safety of the service.
The registered manager had notified the Care Quality Commission (CQC) of all but one incident that occurred in accordance with our statutory requirements. This meant that CQC would be able to monitor risks regarding the service.