Rowans Domiciliary Agency

Rowans Domiciliary Agency (DCA) provides personal care to people living in their own homes in the community. It provides a service to older adults in the St Agnes, Perranporth and Mount Hawke areas of Cornwall. This includes people with physical disabilities and dementia care needs. 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.

Not everyone using Rowans DCA 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 inspection 20 people were receiving a personal care service. These services were funded either privately, through Cornwall Council or NHS funding.

People, and their relatives, told us they were happy with the care they received and believed it was a safe service. People and their relatives commented, “I am very happy with the service, they are doing a good job”, “Brilliant service, it has been life changing for my husband” and “Very good, very pleased with the help.”

People told us they received a reliable service and had regular staff who visited them. People had agreed the times of their visits and were kept informed of any changes. No one reported ever having had any missed visits. People told us, “The timings are good” and “Someone has always turned up and they let me know if they are going to be late.”

Staff treated people respectfully and asked people how they wanted their care and support to be provided. People and their relatives spoke positively about staff, commenting, "[Person] gets on with all the carers” and “Staff are really nice.”

We found staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. People who needed help taking their medicines were appropriately supported by staff.

Care plans provided staff with direction and guidance about how to meet people’s individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person.

The service had robust recruitment practices, which meant they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. Management provided staff with appropriate training and supervision. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age.

There was a positive culture within the staff team and staff spoke passionately about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The registered and assistant managers were clearly committed to providing a good service for people. Comments from staff included, “The management listen and action our feedback”, “The assistant manager works with us” and “They are very good to work for. I can’t praise them enough.”

There were effective quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received. People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive and there was an effective complaints system available.

We gathered evidence of people's experiences through speaking with one person who used the service. We also spoke with three relatives of people who used the service. We spoke with three members of staff who supported people.

People and relatives we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and that reviews were held to reassess their needs. We saw relatives had provided information for people's care plans.

We saw that the care plans were person centred and reflected people's needs. This meant that the care plan was based on the needs of the person. We saw that people's needs were reassessed and where necessary the care plan was updated. We saw that people's likes and dislikes were clear within their care plans.

People and relatives we spoke with told us that staff were friendly and supportive. We saw there were regular members of care staff who provided people's personal care. Continuity of staff should mean that people receive their care consistently as staff have an increased understanding of people's needs.

We spoke with staff about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding abuse.