Archived: Fisher Healthcare Ltd

Before the inspection we looked at all of the information that we held about the service. This included information from notifications received by us. A notification is information about important events which the provider is required to send to us by law.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff received training to protect people from harm and they were knowledgeable about reporting any harm. There were a sufficient number of staff and recruitment procedures ensured that only suitable staff were employed. Risk assessments were in place and actions were taken to reduce identified risks.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions. We saw that no one receiving care from the service was subject to any restrictions on their liberty.

Staff were supported and received ongoing trained to do their job. The staff were in contact with a range of health care professionals to ensure that care and support was well coordinated. Health professionals we spoke with were complimentary and positive about the service. Risk assessments were in place to ensure that care and support could be safely provided.

People’s privacy and dignity were respected and their care and support was provided in a caring and a patient way.

A complaints procedure was in place and complaints had been responded to, to the satisfaction of the complainant. People felt able to raise concerns with the staff at any time.

The provider had quality assurance processes and procedures in place to monitor the quality and safety of people’s care. Staff confirmed that there was an open culture within the management of the agency and that they felt well supported by management staff. People and their relatives were able to make suggestions in relation to the support and care provided.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

People we spoke with told us that they were happy with the care and support they received. We looked at the care records used by the service. These included risk assessments to ensure that care and support was provided in a safe manner.

Procedures were in place to ensure as far as possible that people were not at risk of being abused and that staff understood the required procedures.

Is the service effective?

The recruitment processes that were followed by the provider provided details about potential staff although we did note that employment histories were not explored in sufficient detail in all cases.

Quality assurance measures were in place to identify the effectiveness of the service. This included surveys of people who used the service, relatives, staff and visiting professionals and audits of records and documents ensured that they were accurate and up to date.

Is the service caring?

People who used the service told us that they were well cared for, they were happy with the staff team and with the care provided.

One person said, "The carers are wonderful, they always explain to me what is happening and make sure that I am happy before they continue." Another person said, 'They (the care staff) are really good and go above and beyond what is required of them."

Is the service responsive?

Records showed that an assessment of people's needs was completed before any care or support began. This showed the persons assessed needs and linked to their care plan detailing how those needs were to be met.

The service supported people in meeting a range of differing needs, in some cases this was as a sitting service in case of emergency and in others providing high levels of care both day and night.. Staff received a range of training to ensure they had the skills to respond to people's needs.

Is the service well-led

The service was managed by the owner with support from a management team. They provided day to day leadership and support.

Staff were supervised on a regular basis to ensure their care and practice was at satisfactory level and this included regular spot checks.

There were mixed views from the people we spoke regarding the service and the level of the quality of personal care they received. Generally, people were happy with their current care staff but told us that they had not been satisfied with previous staff. One person said, 'At first, I faced a lottery of carers. Some were good and some not so good'. One relative said, 'The service is excellent. We couldn't have asked for more'.

People's care records were detailed and person-centred. We noted that people received appropriate risk assessments according to their needs. Care and support had been planned to meet people's needs and was reviewed on a regular basis.

All of the people we spoke with confirmed that they felt safe. People spoken with knew how to contact the provider or the deputy manager to raise any concerns.

Generally, staff underwent appropriate training including induction training. We noted that the majority of care staff had not received any supervision following their induction. This was discussed with the provider who told us that this was being addressed.

The provider had basic systems in place to assess and monitor the quality of service provision.