Civicare (Beds Herts & Bucks) Ltd

Civicare (Beds, Herts & Bucks), is a domiciliary care agency providing personal care and support to people in their own home. The service was supporting 87 people at the time of the inspection. There were 48 people receiving the regulated activity of personal care at the time of the inspection.

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

The registered manager had systems in place to make sure that staff were suitable for their role. All staff had checks on their employment history and a criminal record check.

People and relatives told us communication was good and they were encouraged to give feedback on the service. They felt able to raise concerns or suggestions to the registered manager.

People were very happy with the care they received. People told us they felt safe and understood as they had a regular team of staff who they knew well.

One person said, “I feel very safe. Staff have very good timekeeping, and I have the same carers most days, but whoever comes in is very nice. [Staff] collect my medication and will always make sure I take it before I leave. They know my likes and dislikes and I am always treated with kindness and respect. My impression of the service is they are great.”

People were supported by staff who were trained in how to keep them safe and knew how to identify and report any concerns. Staff were encouraged to be involved in scenario-based learning. This helped staff to understand how they might respond and apply the learning to any future incidents or concerns.

People told us staff always collected and administered their medicines correctly. Staff were trained in safe administration of medicines and received regular checks on their knowledge ad practice by the registered manager or a senior supervisor.

Staff had received training in infection prevention and control which included safe management of the risks related to COVID-19. People told us staff always wore the correct gloves, aprons and masks and washed their hands when supporting them in their home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 June 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced inspection of this service on 07 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance and fit and proper persons employed.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Civicare (Beds, Herts & Bucks) on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

The provider’s monitoring process did not look effectively at systems throughout the service. This led to issues and shortfalls in the monitoring of the service and in staff recruitment. This resulted in a risk that people did not receive all of the visits that were due, and that staff may not be suitable to work with people.

People were safe using the agency because staff knew what they were doing. They had been trained and visited people to learn how to care for them before having to do so.

People received their medicines from staff who knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks if needed. They did this in a hygienic way, using protective equipment, such as gloves and aprons. Staff followed advice from health care professionals and made sure they asked for people’s consent before caring for them.

People liked the staff that cared for them and they described them in a warm and positive way. They went on to tell us that staff supported them to live as they wanted. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the service’s aim to deliver high quality care, which helped people to continue to live in their own homes.

We have made a recommendation that the provider obtain information about long term health conditions.

Rating at last inspection: Good (report published 26 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as scheduled in our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service provides personal care to adults and children with a variety of care needs in their own homes. Some of the 50 people being supported by the service at the time of the inspection were living with dementia.

There was a registered manager 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.

There were risk assessments in place that gave guidance to staff on how risks to people could be managed. There were systems in place to safeguard people from risk of possible harm and suitable equipment was in place so that people were supported safely. People’s medicines were being managed safely.

The provider had safe recruitment processes in place and they had sufficient numbers of staff to support people safely. Staff had received regular supervision and support, and they had been trained to meet people’s individual needs.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this had been managed in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by kind, caring and respectful staff. They were supported to make choices about how they wanted to be supported. People’s health and wellbeing was promoted, and they were supported to access healthcare services when urgent care was required.

People’s needs had been assessed and their care plans took account of their individual needs, preferences, and choices. The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service and their relatives, and they acted on the comments received to improve the quality of the service.

The provider had effective quality monitoring processes in place and these had been used effectively to drive continuous improvements. Most people described the service as ‘very good’. They had no concerns about how their care had been managed and they found communication with office staff to be mainly good.

The staff we spoke with during this inspection were knowledgeable about the people they provided care and support for. We looked at training and staff support records, which confirmed that staff performance and competency was monitored and managed effectively by the provider.

We spoke with three of the 11 people who received personal care from this service, or where more appropriate, their relative. We found all were very satisfied with the service they received. They all spoke highly of the staff that provided their care, and said that the manager was always available if they had any concerns. The relative of one person said. "--- thinks they're the best thing since sliced bread, and I can't fault them either."

The provider had systems in pace to monitor the quality of service provision.

We noted from the three care files that we looked at, that people were offered support at a level which encouraged independence and ensured that their individual needs were met. People told us that the staff were polite and courteous in their approach and were knowledgeable and confident in their roles. One person told us, "I get on very well with my carer". Someone else said "The girls know what they are doing, I have no concerns at all".

We could see from records that people were encouraged to express their views, and were involved in planning and making decisions about their care and support. The provider welcomed suggestions from people which could improve the service they provided. People told us that they felt able to approach the manager to discuss anything, and they were confident that action would be taken swiftly to resolve any issues they had.