Care Dynamics Ltd

About the service

Care Dynamics Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. Some of these people have a learning disability and other people are older people. At the time of the inspection the service was providing personal care to 56 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

Right Support

Staff knew people well and risk assessments detailed action staff should take when providing daily care and support. People told us they were happy with the service they received from Care Dynamics Ltd. 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. Staff promoted independence every day for people. Medicines were managed and administered safely.

Right Care

People told us they felt safe with staff. People were protected from abuse and avoidable harm. People received their care from a consistent team of care staff who knew their care and support needs well. Staff received training to support people using a person-centred approach; one person told us, “The carers take my family into consideration.” The registered managers liaised with health and social care professionals when they needed an expert’s input regarding people’s health or identified additional time was needed to continue to provide care safely.

Right Culture

People using the service, staff and health and social care professionals consistently described the registered managers as “present,” “contactable” and, “will try their best to help resolve any concerns”.

Staff received an appropriate induction and were well supported through a programme of regular supervision and training. Staff spoke knowledgably about how people preferred their care and support to be given.

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 outstanding (published 15 February 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from outstanding to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

• Without exception, everyone we spoke with praised the service they received and were treated with kindness, compassion and respect. An example of the comments we received was “They are wonderful. I can’t praise them enough”.

• People consistently told us how they received care from staff who knew their needs well, at times when they expected them and this helped to make them feel safe.

• We received extremely positive feedback on how staff went over and beyond what they were expected to in order to provide a truly person centred service.

• People and staff described how the service made them feel respected, valued and listened to. Respect for privacy and dignity was at the heart of the service's culture and values.

• There were high levels of satisfaction across all staff. Staff described being "Proud" to work for Care Dynamics, and how they had worked for other companies and there was "No comparison." Staff were enthusiastic at the opportunities they had to improve and develop by being encouraged to gain additional qualifications, as well as being able to progress in their career by being promoted to senior roles.

• The whole service continued to have a good track record and recently received the Home Care Provider of the year 2018 award from the Local Authority ‘Proud to care’ campaign.

• More information is in the full report.

Rating at last inspection:

GOOD (The date last report published was 20 June 2016).

About the service: Care Dynamics Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. Some of these people have a learning disability and others are older people. At the time of our inspection they were providing personal care to 37 people.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved and has been rated Outstanding.

Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Outstanding.

At our last inspection in July 2014 we found a breach in the regulations relating to the recording of prescribed skin creams. At this inspection we found that improvements had been made to meet the requirements of the regulations.

Care Dynamics Ltd provides personal care and support to people who live in their own homes. Some of these people have a learning disability and others are older people or have physical disabilities. At the time of our inspection they were providing personal care and support to 29 people.

The service is required by law to have a registered manager, and there were two well-established registered managers 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.

Everyone we spoke with was happy with the service they or their relative received and complimented the caring nature of the staff. They had a regular team of workers who knew them and understood their care and support needs. They were kept informed of any changes to their timetable or if staff were running late.

Staff received training, which was refreshed at regular intervals, to ensure they had the skills and knowledge they required to be able to provide care safely. Their performance was monitored regularly and they were themselves supported through supervision meetings with their line manager.

Quality assurance systems were in place to monitor and where necessary improve the quality of service being delivered. One of the registered managers had developed the audits to give them a better overview of the service and to identify any trends that suggested a change in practice was needed. The service participated in local initiatives to promote good practice in care delivery and to encourage people to consider careers in social care.

The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

We considered our inspection findings to answer questions we always ask:

' 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?

Care plans addressed risks to people's health, safety and welfare. We saw that care records contained person-specific risk assessments and management plans. These addressed any risks identified for the person, such as the risk of falling, or risks associated with heath conditions such as diabetes.

People were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. Staff lacked clear instructions about how to assist or prompt people to apply their creams. Staff assisted a person with their skin cream but did not record this in the person's medicines administration records. The staff we spoke with told us that they generally recorded any assistance or prompting they gave people regarding their skin creams in care logs rather than in medicines administration records.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The people we spoke with all indicated they felt safe with staff and said that staff treated their property with care. Support workers were aware of signs or issues that could indicate a concern.

Appropriate checks were undertaken before staff began work, to help ensure that staff were safe to work with people.

Is the service effective?

People were positive about the care and support they received. Both people with learning disabilities said they had a programme of activities that they had chosen themselves and that their support workers helped them to follow this. One person said that their regular staff were 'superb' and 'know what sort of things I need and I like'.

Is the service caring?

People told us they liked their support workers. For example, one person said their support workers were 'really good' and another person described them as 'nice and kind'. We visited three people in their own homes and observed that they had a good rapport with their staff, who treated them respectfully.

Is the service responsive?

Care plans reflected people's assessed needs and contained instructions for care workers so that people received the help and support they needed. The care records we looked at showed that people's needs had been assessed before they received a service. People told us that they had been consulted about their care plans. One person told us, '[The manager] came and went through it all and made sure that I was happy with it.'

People told us they had a regular team of support workers, received a rota in advance so they knew who to expect, and said that staff generally arrived promptly.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. All six people we spoke with told us they felt able to raise any concerns about their or their relative's service with the management.

Is the service well-led?

The provider had an effective system to regularly assess and monitor the quality of service that people receive, and to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The registered manager sent out quarterly quality assurance surveys to people who use the service, and senior staff also telephoned or visited people to check their satisfaction with the service. A relative told us, 'Every so often you'll get a phone call asking if there are any concerns or problems.' There was a system of spot checks in place to ensure that staff followed Care Dynamics Ltd policies and procedures.