Archived: Krystal Care Limited

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults. Not everyone using Krystal Care Limited 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 our last inspection on 20 April 2016 we rated the service ‘Good’. However, ‘Safe’ was rated ‘Requires Improvement’ with a breach in Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to one staff member’s recruitment. Following the last inspection the provider sent us an action plan, detailing what action they would take and when, to meet this breach in regulation.

At this inspection, we found the evidence continued to support the rating of ‘Good’ and improvements had been made in ‘Safe’ and the breach in regulation had been met. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service met all relevant fundamental standards under ‘Safe’. People were protected from abuse and avoidable harm. Risks were assessed and planned for and information to support staff was reviewed when changes occurred. There were sufficient staff employed to meet people’s needs and safe staff recruitment practices were used. Action was taken to respond to any accidents or incidents and lessons learnt were considered. Staff were aware of good infection control measures.

The service met all relevant fundamental standards under ‘Effective’. The management team were very experienced and kept their knowledge up to date with best practice guidance. People’s diverse needs were assessed and people did not experience discrimination. Where people required support with eating and drinking this was provided. Staff took action if they identified a deterioration in a person’s health. People were asked for their consent before they received care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service met all relevant fundamental standards under ‘Caring’. Positive feedback was gained about the approach of staff and their knowledge about people’s support needs. Staff treated people with dignity and respect and supported and encouraged independence. Advocacy information had been made available for people. People were involved in opportunities to discuss their care package.

The service met all relevant fundamental standards under ‘Responsive’. People’s needs, preferences and routines were known and understood by staff. People were involved in their assessment and ongoing reviews. The Accessible Information standard was understood by the management team. The provider’s complaint procedure had been made available

The service met all relevant fundamental standards under ‘Well-led’. The management team had effective systems and processes in place to monitor the quality and safety of the service. Where improvements were identified, action was taken to meet any shortfalls. People who used the service received opportunities to feedback their experience about the service. There was an open and transparent culture. Staff were aware of the provider’s values and respected these in their everyday work.

Further information is in the detailed findings below.

The service had a registered manager. 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 provider had not carried out all of the required pre-employment checks on staff which meant people were exposed to an avoidable risk. There was a sufficient number of staff available to meet people’s needs and people received the support required to safely manage their medicines.

People told us they felt safe and staff understood their responsibilities to protect people from the risk of abuse. Risks to people’s health and safety were assessed and appropriately managed.

Staff were provided with the knowledge and skills to care for people effectively. People received the support they required to have enough to eat and drink. Staff acted appropriately in contacting healthcare professionals and supported people to attend appointments if required.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Procedures were in place to act upon any concerns about people’s capacity to make their own decisions. People were asked for their consent before receiving any care.

There were positive and caring relationships between people and staff because staff took the time to get to know the people they supported. People and their relatives were able to be fully involved in the planning and reviewing of their care and staff supported people to make day to day decisions. People were treated with dignity and respect by staff who understood the importance of this.

People were provided with care that was responsive to their changing needs. There was a system in place to monitor staff punctuality and ensure that people always received the care required. There was a clear complaints procedure in place which was provided to people when they started using the service. The provider responded well to any comments they received.

People were asked for their opinions about the quality of the service they received and action was taken in response to any issues raised. There were effective systems in place to monitor the quality of the service and these resulted in improvements to the service where required.

We spoke with two relatives of people using the service. We were told that the level of care provided met people's needs. One relative said, 'There have been issues in the past but I am very happy with the care at the moment.' One relative mentioned that staff sometimes did not arrive on time however it was acknowledged that this hadn't caused any problems in the delivery of care.

We spoke with two members of staff who told us that they always had access to the necessary protective equipment. One member of staff said, 'There is always plenty in the office if I need to stock up. If required a manager will drop some off at somebody's house.' Staff were provided with training in infection control practices and were aware of how they could protect themselves and others from the spread of infection.

Staff received professional development and supervision. There was an effective complaints system available.