Archived: Farringford Care Limited

The inspection was carried out by one inspector. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe? :-

People told us they felt safe and trusted the staff. People whose care included use of equipment such as a hoist told us, 'The staff know what they are doing. They are very competent when using the equipment' and 'My wife has two carers at a time, they use a hoist to reposition her. She trusts them and feels safe with them.'

Although we found some improvements to the recording of assistance given with the prompting and administering of medicines, the manager acknowledged more improvements were required to ensure all medicine recording systems were clear and safe. One relative told us, 'The staff are very careful with mum's medicines. They have to take them out of the box and watch her take them. They always record this and let us know if there have been any problems.'

Procedures for dealing with emergencies were in place and staff were able to describe these to us. There was an on- call system to ensure people could contact the agency outside office hours. We saw staff had received training in first aid and basic life support.

Recruitment practices included checks to ensure new staff were safe to work with people who used the service. Policies and procedures were in place to make sure that unsafe practices were identified and people were protected.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective? :-

People's care was coordinated with other health and social care professionals in the community and when admissions to hospital were required. One person told us, 'The office staff have always been most helpful if I've had to change the visit times.'

People told us they were involved with the development of their plans of support and consulted about any assessment of their health and care needs.

People were provided with a choice of suitable and nutritious food and drink. They told us when care workers were involved in preparing meals for them they were offered choice and staff followed good hygiene practices. One person commented, 'They prepare nice meals and snacks.'

Is the service caring? :-

We spoke with people who used the service and their relatives about the care workers who visited them and the support they provided. Feedback was very positive and comments included: 'Excellent staff, can't fault any of them', 'Lovely staff, very dedicated and caring', 'Always punctual and reliable', 'The staff know my routine and how I like things done, never rush me' and 'Always professional and kind.'

People's preferences and routines had been recorded; care and support was provided in accordance with people's wishes and choices. Staff demonstrated they knew people's needs and preferences.

When speaking with staff it was clear that they genuinely cared for the people they supported. People who used the service and their relatives indicated they had positive relationships with the care workers who visited them. They confirmed they were regularly consulted about their views concerning the way the service was provided.

Is the service responsive? :-

Care workers told us that if they identified that people's needs had changed they would report this to the office and a senior member of staff would reassess the person as soon as possible. People confirmed their support was reviewed regularly and increased where necessary.

People were able to complain and we saw any complaints received were investigated and addressed. They told us that where shortfalls or concerns had been raised, these were taken on board and dealt with appropriately. A relative said, 'I've raised a few niggles and they sorted things out.'

Is the service well-led? :-

Generally, we saw there were good systems in place for the development and monitoring of care packages. Senior staff completed annual reviews of care with the person and their family or representative.

The service had a quality assurance system, which included audits and seeking people's views. We found some improvements had been made with rota management to improve the consistency of care workers allocated to a care package and times of the visits. Also staff sickness and absence rates had improved with increased monitoring. Some people told us that their main care workers were excellent but improvements could be made when planning their replacements during holidays. Comments included, 'No problems with my regulars, they are marvellous, couldn't manage without them. I know it is difficult with holidays and sickness cover, but a bit more consistency would help' and 'Very happy with all the carers and the help they provide, they are usually very punctual.'

Staff told us they were clear about their roles and responsibilities, had access to training and were well supported by management. Staff had an understanding of the ethos of the service and worked well as a team. One member of staff told us, 'It's a good company to work for; the management are supportive and we get plenty of training.'

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Although there were some comments about a lack of consistency with the group of carers people sometimes received people were generally satisfied with the care they received. Comments included, 'Without a doubt it is the best company we have been with."

There were effective systems in place to reduce the risk and spread of infection. People who used the service told us that staff used the equipment provided and practiced good hand hygiene.

People were not always protected against the risks associated with medicines. This was because staff were not always following procedures relating to record keeping, staff were administering medicines from boxes made up by third parties, the manager could not evidence staff had received training relating to specific medication tasks they were undertaking and people did not always get their medicines as prescribed.

There were enough qualified, skilled and experienced staff to meet people's needs and people who used the service told us they were generally satisfied with their carer's. However some people told us they did not always receive a consistent group of carer's.

Staff received training and support to help them to do their job to a good standard.

They told us that they were satisfied with the service they received. Comments included "We are thrilled with Farringford, I can't praise them highly enough" and 'The service is very good and the carers are excellent.'

We found that there were detailed care plans in place and that these had been regularly reviewed. People told us that they had received a care plan and that this had been discussed and agreed with them.

We found there were systems in place to ensure the safe use of equipment. One person who used the service told us "The staff seem competent in the use of the hoist and they are coming tomorrow for training on the new hoist which has just been provided."

We found that there were effective recruitment and selection processes in place. Staff received training for their role and this was regularly refreshed. People who used the service were very complimentary about the staff. One person told us that "Staff are very good and very conscientious."

We found there was a complaints procedure in place. Some people we spoke with were unsure if they had been given information about the complaints procedure, but other people said they had written information in their care file. They all felt able to contact to the office with any concerns.