Archived: Safe & Sound Homecare Services

Safe & Sound Homecare Services is a domiciliary care service providing personal care and support for people living in their own homes within a seven mile radius of Radstock. At the time of the inspection they were providing personal care for 40 people.

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 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 care and support that was safe. The provider had a robust recruitment programme, which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in recognising potential abuse and how to raise concerns. Medicines were managed safely. Staff were trained in administering medicines and their competency checked regularly.

People received effective care and support that was focused on the person. There was a consistent staff team which meant people had regular care workers whom they knew well. Staff received mandatory training as well as training specific to people’s individual needs. Staff demonstrated a good understanding of people’s needs and how they preferred to be supported.

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 were supported by caring staff who respected their independence and supported them with dignity and respect. People told us staff were caring and often went above and beyond what was expected of them.

People received responsive care and support which was personalised to their individual needs and wishes and promoted independence. There was clear guidance for staff on how to support people in line with their personal wishes, likes and dislikes. One person told us how they maintained control over the care and support provided. They said they discussed their care plan and the staff they were supported by regularly with team leaders or the registered manager.

There were systems in place to monitor the quality of the service provided, ensure staff kept up to date with good practice and to seek people’s views. Records showed the service responded to concerns and complaints and learnt from issues raised.

People and staff spoke positively about the registered manager. Staff said they felt valued and supported by the registered manager and provider.

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

Rating at last inspection

The last rating for this service was requires improvement (published 23 October 2018), and we found one breach. 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.

Safe and Sound is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, some of who may be living with dementia.

Not everyone using Safe and Sound 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 the inspection, there were 67 people receiving personal care from the agency. Safe and Sound provides care and support in the Radstock area.

The service had 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.

The staff did not work within the principles of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Capacity assessments and best interest decisions were not always in place where required. There were inconsistencies in seeking and recording consent for people with fluctuating capacity. Care records lacked detail on the specific decisions people who were assessed as lacking capacity would require support to make. Staff told us they sought people’s verbal consent before they provided care and support and recognised this was an important part of their role in promoting choice and independence.

Some people took responsibility for their own medicines management while staff supported others. For those who needed staff support, there was no audit of record to ensure staff had signed to indicate they had given people the prescribed medicine. There were no PRN protocols to inform staff when to offer people medicines that they may take ‘as required’.

People were supported by staff that were competent and had received training to ensure they had the skills and knowledge to carry out their roles. Staff received supervision and appraisals and felt recognised for their work.

People were supported by staff who used personal protective equipment correctly to reduce the risk of cross infection. Care plans contained risk assessments which identified potential risks to people. However, care plans were not person centred and did not contain important information relating to preferences or detailed routines required for staff to provide consistent and safe care.

People were supported by staff who had checks undertaken prior to being employed by the service. There was sufficient numbers of staff and people received support from a consistent staff team who were familiar with their needs.

Staff could demonstrate a good understanding of abuse and who to go to should they have concerns. Staff were kind and caring. Relatives told us they were notified whenever changes in their relative's condition had happened, and health professionals were referred to for advice and treatment.

Feedback and views of people using the service were sought and people and relatives were complimentary about the office management team. They felt able to raise concerns with the registered manager who they felt was accessible.

The service had a quality assurance system which had not identified shortfalls in the medicines administrative records audit. Care plan audits had not identified inconsistences in the recording of people’s mental capacity.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

At this inspection we spoke to four people who used Safe and Sound Homecare Services, and all of these people spoke positively about their experiences of care.

We spoke to two members of staff who told us about the new quality assurance system and training system that has been put into place following our last inspection.

We looked at ten sets of employment and training files and saw that the training has taken place in accordance with the action plan which was submitted following our last inspection. Safe and Sound Homecare Services had forward planned dates for training on a calendar so that the management can see what training is required at a glance and maintain the levels of training in future.

We saw that the new systems in place were aiding the manger in responding to issues and risk assessing situations promptly. This meant that Safe and Sound Homecare Services have improved their monitoring systems to adequately provide safe and effective care for people who used the service.

We looked at three care plans of people using the service and found full assessments of needs and consent forms in place for people using the service. Risk assessments were in place in all cases for risk of tissue breakdown and moving and handling.

Three people we visited had positive things to say about the people that provided care in their homes. One said 'sometimes they do things above the call of duty'. Another person said 'not one amongst them I could find fault with'.

We spoke to two care workers who told us that they felt supported and listened to by their employers.

We saw a training matrix and noted that out of the 19 staff on the matrix, four had current medication training, seven had first aid training, and seven had moving and handling. This level of training did not meet the mandatory requirements that the provider had set themselves.

The quality monitoring systems were not always effective enough to identify issues and therefore to improve services.