Archived: St Margarets Homecare Harrogate

St Margarets Homecare Harrogate is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults.

Not everyone using St Margarets Homecare Harrogate 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. Where they do we also take into account any wider social care provided. At the time of our visit there were 99 people using the service.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service continued to provide safe care to people. Recruitment checks were completed on all new staff prior to their employment to make sure they were suitable. Appropriate systems were in place to assess and manage potential risks to people including the risk of abuse. Risks to people’s safety and welfare had been assessed and information about how to support people to manage risks was recorded in people's care plan. Systems were in place to ensure people received their medication safely.

Staff received on-going training and supervision to enable them to fulfil their roles effectively. Staff were clear about their roles and responsibilities and they told us that senior managers were supportive.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff liaised with healthcare professionals to support people’s health and wellbeing. Staff continued to work collaboratively with the local hospice team in relation to people’s complex care needs and end of life care.

People spoke positively about the staff and they said staff were kind and respectful. People were involved in their care and were supported to remain independent.

Staff were knowledgeable about people’s lifestyle choices and their individual needs and preferences. Care plans were person centred. People told us staff were flexible and accommodated any changes to their requirements wherever possible.

People’s care plans were reviewed to meet their changing needs and staff told us they felt well informed about people’s wellbeing and how to meet their care needs effectively. People told us they had not needed to make a complaint, but they knew who to speak with if they had any concerns. .

The service provider was a partnership. Both partners maintained an active daily presence in the service and one of the partners was also the registered manager. The registered manager, together with senior care staff carried out a range of monitoring checks to drive quality development and make improvements where needed.

At the last inspection of the service on 20 January 2014 the provider was meeting all of the regulations that were assessed.

St Margarets Homecare is registered to provide personal care to people who live in their own homes. The agency primarily supports people in the Harrogate and Ripon area and surrounding villages.

The registered provider is a partnership of two people, one of whom is the 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.

We received some conflicting information from people who used the service and their relatives. While people were satisfied with their care workers they also told us about recent staff changes and lack of staff training for new staff. When we visited the agency office the registered manager confirmed that recent staff difficulties had impacted on the service they offered and it had been a very difficult year. However they were also able to tell us about the management systems which they had put in place to improve the service. For example, they had appointed two senior care workers who were working with them to improve audit system and review and update staff training.

People told us the service was flexible and wherever possible accommodated any changes to their requirements. Risks to people’s safety and welfare had been assessed and information about how to support people to manage risks was recorded in people's care plan. Staff said that they would speak with the registered manager if they had any concerns about people’s safety and welfare.

Appropriate checks were made as part of the service’s recruitment process. Newly appointed staff had undertaken an induction programme and arrangements were in place for staff to complete updated mandatory training on medicines management.

Effective systems were in place to provide staff support including supervision sessions and staff meetings. Staff told us they felt confident in the management of the service and that the providers were approachable and supportive.

Staff liaised with healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing and we found evidence of good collaborative work with the local hospice in relation to people’s end of life care needs. People’s care plans were reviewed to meet their changing needs and staff told us they felt well informed about people’s needs and how to meet them.

Staff demonstrated a good understanding about the requirements of the Mental Capacity Act 2005 (MCA), which aims to protect people who may not have the capacity to make decisions for themselves.

People told us that they were happy with the care and support they received and that staff were caring and kind and treated them with respect and dignity. When giving their feedback people expressed a strong preference for the care workers with whom they were familiar. Staff said wherever possible they tried to keep a consistent team working with the same people. The registered manager told us that they had introduced a new key worker system to act as the first point of contact for people, families and staff to improve consistency. Staff we spoke with told us how much they enjoyed working for the service and were committed to providing an excellent service for people.

Not everyone who gave us feedback knew about the complaints procedure however people told us they knew how to contact the office if they had any queries. Some people told us that they would speak with family or their social worker in the first instance.

Systems and processes were in place to monitor the service and drive forward improvements. This included planned improvements to the internal audit systems and better ways to gain people’s feedback.

We saw from people's care plans that people were supported to live as independently as possible. The agency had carried out sufficient assessments of the needs of each person and kept this under review. This ensured that appropriate care and support was given. One person told us, 'I am quite pleased with the agency' another person said, 'St Margaret's are extremely good. I have been with them for a number of years.'

The agency had in place policies and procedures covering medication. People told us they received their medication at the right time. Staff working for the agency received regular medication training. This made sure that people received their medication as prescribed.

We reviewed the recruitment and selection processes for new staff and found them to be robust. This ensured that people were supported by suitably qualified, skilled and experienced staff.

The agency had systems in place to make sure people were safely cared for. This included policies and procedures and quality monitoring systems.

Everyone who used the service said staff from the agency had visited them prior to arranging the care package. They said they had received all the information they needed about the organisation, before they made a decision to use them. People also told us that they were treated with respect by their care staff. Comments made to us by people who use the service and their relatives included 'They are very friendly and helpful, new staff are always introduced to me and if they are going to be delayed someone rings me to let me know.' One person told us 'They are always willing to accommodate my requests, I am very satisfied. The manager came to see me and we talked about what I wanted.' Another said 'I talked to the manager about what I wanted and that's what the staff do for me'. and 'I have no complaints and if I did I feel I could talk to the manager about it and she would listen'. This meant that people were involved in planning and making decisions about the care they wanted and meant that the agency was responsive to individual needs.

We spoke with two members of staff by telephone and one in person about their job roles. They told us told us that the agency was very supportive, particularly emergency out of office support and provided good opportunities for training. This meant that the agency's staff were provided with the training and support they needed to do their jobs.