This announced inspection took place on the 10 and 11 May 2018. It was announced 48 business hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. Our last inspection of the service was carried out on 31 July 2015. At that inspection we rated the service as good. At this inspection we found the service remained good.Victoria Community Care (CC) is a Domiciliary Care Agency that provides care and support to adults, in their own homes. The service provides help and support with people’s personal care needs in St Austell, Par, Roche, Mevagissey, Gorran Haven and surrounding areas. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.
At the time of our inspection 64 people were receiving a personal care service. These services were funded either privately or through Cornwall Council or NHS funding. There were 44 staff employed some of those were office based to coordinate and manage the service.
There was a registered manager in place at the time of our inspection. 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.
People were extremely satisfied with the quality of the service they received and the caring approach from staff. People told us; “They are amazing,” “They are my lifeline” and “We are very blessed, they are marvellous, very professional.”
People told us they had not experienced a missed care visit. The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service's visit schedules were well organised and there were a sufficient number of staff available to provide people's care visits in accordance with their preferences.
People told us that their visits were on time but there were 'rare occasions' when care staff could be late for their planned visits. However people, and relatives, did not have a concern regarding this as they understood that any lateness was due to care staff needing to provide extra support to a person in an emergency or due to travel issues, especially in holiday seasons. People told us that Victoria office staff would phone them if a care worker was going to be late which gave them reassurance that their visit would still continue. Victoria operated an on call system outside of office hours. Care staff told us managers would respond promptly to any queries they might have.
People received care and support from a consistent team of staff with whom they were familiar. Staff arrived on time and stayed for the full time allocated. People spoke positively about the staff that supported them and told us they were always treated with care, respect and kindness. Staff were respectful of people’s privacy and maintained their dignity. Staff had developed good relationships with people and were familiar with their needs, routines and preferences.
Staff were respectful of the fact they were working in people's homes. The service offered flexible support to people and were able to adapt in order to meet people's needs and support them as they wanted.
There were processes in place to protect people and the security of their home when they received personal care, including staff wearing uniforms and carrying identification. People received information about who they should expect to be delivering their care so they were aware of who was due to call upon them.
Safeguarding procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and wellbeing had been assessed and managed.
Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided. Accidents and incidents were reported and reviewed to reduce the risk of an incident occurring again.
Medicine procedures were safe. The service supported people with their medicines by prompting them. Records showed when prompts had been made in the daily records at people’s homes.
Staff were recruited in a safe way and available in sufficient numbers to meet people's needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.
Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them in any way. People's legal rights were understood and upheld. Everyone told us staff ensured their dignity and privacy was promoted.
People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act.
People's care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people's care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person's individual needs and wishes. The service's risk assessment procedures were designed to enable people to take risks while providing appropriate protection.
Staff supported people to have a nutritious dietary and fluid intake, assisting them to prepare and eat food and drinks as they needed.
The registered provider and management team provided clear leadership to the staff team and were valued by people, staff and relatives. There was a whole team culture, the focus of which was how they could do things better for people.
People and relatives all described the management of the service as open and approachable. People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.