Archived: Care Full Care Limited

This announced comprehensive inspection took place on 25 and 31 August 2016. We gave the service 48 hours’ notice of our inspection.

The service had a registered manager in place. 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 visions and the values of the service were put into practice by the management to ensure an open and transparent approach to the way staff were supported.

The provider’s policy on administration and recording of medicines had been followed, which meant that people received their prescribed medicines. The medication policy was being reviewed and updated at the time of the inspection because the information was not appropriate or applicable to the service provided.

People had their needs assessed so that staff knew how to support them to maintain their independence. People’s care plans were reviewed and updated and contained person- focussed information. However, although plans were in place to minimise people’s identified risks these had not always been updated. This meant that people could be at risk because staff did not have the up to date information they needed.

There was a sufficient number of staff available to ensure people’s needs were met safely. The risk of harm for people was reduced because staff knew how to recognise and report abuse. Staff were aware of the procedures for reporting concerns, systems were followed and concerns were investigated.

Staff were only employed after representatives of the provider had carried out comprehensive and satisfactory pre-employment checks. Staff were supported by the registered manager and senior staff through supervisions and staff meetings.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. We found that staff were trained in the principles of the MCA and could describe how people were supported to make decisions. This meant that any decisions made on people's behalf by staff would be in their best interest and that any safeguards put in place would be as least restrictive as possible.

People received care and support from staff who were kind, caring and respectful to them. Staff treated people with dignity and respected their privacy.

People knew how to make a complaint. The provider investigated any complaints and as a result made changes to improve the service.

The registered manager was supported by a staff team that included a number of other managers and care workers. The service had a quality assurance system in place. People and relatives were encouraged to provide feedback on the service and their views were listened to and acted on.

' 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 discussions with six people, and three relatives of people, who use the service, and three care workers. In addition we looked at five peoples care records and three staff member's records.

Is the service caring?

People experienced care and support that met their needs and protected their rights. Without exception, people made very positive comments about the service they received. They told us that they were, 'Very satisfied' and, 'Very happy' with the service. They said that the care was provided in a consistent way with as few staff providing personal care as possible. The majority of people we spoke with said this was very important to them.

We saw the agency had received numerous compliments from people and their relatives about the service that had been provided. A typical comment was, 'The excellent care your staff gave made all the difference to us.'

Is the service responsive?

There was an effective complaints system available. No complaints had been received in the last 12 months. People told us that they felt the agency staff responded quickly if they raised any concerns.

There were suitable arrangements in place to obtain the consent of people who used the service. People said that they consented to their plan of care and the care provided on each occasion. One person said, "The [care worker's] always check with me before doing my care. They are very considerate.'

People who used the service, and where appropriate, their representatives, were asked for their views about the care provided and these were acted on.

Is the service safe?

There were enough qualified, skilled and experienced staff to meet people's needs. People told us that their care workers generally arrived on time and that they were usually informed if their care worker was running late. They said they felt care workers understood the care that was required and were competent to provide this.

People were protected from the risk of infection because appropriate guidance had been followed.

Is the service effective?

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

People said that their care was provided by as few care workers as possible. They said this helped maintain the consistency of their care and meant that people using the service developed good relationships with staff members. One person told us, 'We've a friendly but professional relationship [with the care workers]. We've set the tone and it works well.'

Is the service well-led?

The agency was effectively managed and staff told us there was always someone available if they needed support. We saw that the manager maintained an overview of the quality of the service by ensuring that various checks were carried out and taking action where shortfalls were found.

The manager sought the views of people who used the service through questionnaires, telephone contact and face to face reviews. We saw the manager acted on what people told them.

We found that the provider was compliant with the regulations in all the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.

You can see our judgements on the front page of this report.

People using the service told us they were happy with their care. One relative we spoke with told us the service was excellent. Another relative told us the service provided: 'The best care we have had'.

One health care commissioner we spoke with told us that the service engaged actively with other agencies to ensure that people using the service got the support they needed.

We found that care records were up to date and provided staff with concise information to help them quickly identify the person's care and support needs. However, records we looked at showed that risk assessments of people's care needs were not sufficiently detailed to ensure that people were cared for safely. We have asked the service to take urgent action to address this.

Staff we talked with spoke knowledgably about the steps they took to protect vulnerable adults.

Staff felt well supported by their manager and told us they had received the training they needed to meet people's care and support needs.

We found that the provider had taken effective action to address the identified concerns and significant improvements had been made in relation to medication recording for people and staff support as a result.