Archived: Complete Care Services Nelson

Complete Care Services (Nelson) is a domiciliary care agency located in Nelson, Lancashire. It provides personal care to people living in their own homes. It provides a service to older adults. At the time of the inspection it provided care and support to 72 people.

At the last inspection on 27 October 2016 the service was rated as ‘Good’. At this inspection we found the service remained Good.

There was a registered manager in place. The registered manager also managed other domiciliary care services located in East Lancashire that were owned by the provider. 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.

People told us they felt safe and were happy with the way they were treated by staff. They told us staff were caring and friendly. People said that they had positive relationships with staff at all levels within the service including managers and representatives of the provider. They spoke positively about the attitude and management of the service.

There were sufficient staff deployed by the service to meet people's needs and staff received safeguarding adults training. Staff we spoke with demonstrated a good understanding of safeguarding practices and their immediate responsibilities with regards to safeguarding vulnerable adults. They were also aware of their responsibilities for reporting incidents and safeguarding concerns.

People were supported by staff who had the skills and training to effectively meet their needs. They also received support to maintain a balanced diet where this was part of their care plan and were supported by staff to access healthcare services where required.

People and relatives told us they had been consulted about their care needs and were involved in day-to-day decisions about their care and treatment. They told us staff treated them with kindness and compassion and respected their privacy.

People had care plans in place which were reviewed periodically, in line with the provider's policy and improvements were noted in relation to the accuracy in the details of people's care planning. Risks to people's health and safety had been identified and assessed.

The care manager, the provider’s representative and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the need to raise a Court of Protection application if there were concerns over someone’s liberty being infringed.

People's capacity to make their own decisions had been assessed in line with the requirements of the Mental Capacity Act 2005. Staff had received training in this area. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff received regular supervision and an annual appraisal of their performance. They told us they felt well supported by the registered manager and worked well as a team. The service sought the views of people through annual questionnaires and the registered manager visited people's homes.

People were aware of how to raise their concerns and complaints and were confident they would be listened to.

Complete Care Services Nelson is registered with the Commission to provide personal care. The agency provides domiciliary care services within the borough of Nelson and surrounding areas. The range of services provided includes personal and social care and domestic assistance. The agency office is staffed during the hours of 9:00 am to 5:00 pm, with a 24-hour on-call system for emergencies. At the time of our inspection there were 82 people receiving a service.

We last visited Complete Care Services Nelson on the 14 & 15 January 2014. The service was fully compliant in all areas assessed.

At the time of this inspection 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.

During this inspection we found the service was meeting the current regulations.

People using the service received care and support from a team of staff who had been recruited safely and trained to deliver safe and effective care and support. People told us they felt safe from abuse or harm and they were treated with respect. They said staff were trustworthy and respected their home. They also told us they felt safe in their homes because staff followed their instructions to gain access to their property and they left their homes secure when leaving.

People using the service and their relatives described the service as being “Very good”, “First class” and “Exceptional”. We were told staff were very respectful, attentive to their needs and treated them with kindness and respect when providing their support. Staff were also described in such terms as being “Really lovely”, “Absolutely wonderful” and “Lovely people”.

Staff had been trained in safeguarding vulnerable people and knew what to do if they suspected any abusive or neglectful practice. Safeguarding procedures were in place to guide and direct staff in reporting any concerns they had. People we spoke with knew what to do if they had any concerns regarding the staff who supported them.

Risks to people’s health, welfare and safety were managed very well. Risk assessments were thorough and informed staff of the actions to take to support people safely. People knew they could contact the agency at any time and had emergency contact details for out of office hours.

There were appropriate arrangements in place to support people to take their medicines. People received their medicines as prescribed, by staff that had been trained to do this safely. People we spoke with told us their visits were arranged to ensure they got their medicines at the right time.

Staff knew what to do in emergency situations and had guidance around keeping themselves and people they supported safe. Good arrangements were in place for staff to gain entry into people’s homes without placing them at risk. Staff were provided with protective equipment such as disposable gloves and aprons to minimise the risk of cross infection between the people they visited and they had been trained to move people safely.

Staff were trained in the principles of the Mental Capacity Act 2005 and understood the principles of ‘best interest decisions’ regarding people’s care and support. People’s diversity was respected and care plans were well written, person centred and focused on the needs of people using the service. People’s right to privacy, dignity, choice and independence was considered and reflected in their care plan.

Staff felt confident in their roles because they were well trained and supported by the manager to gain further skills and qualifications relevant to their work. Staff were effectively supervised and were subject to spot checks to make sure high standards were being maintained at all times.

Staff had been trained in ‘End of Life Care’. This meant people receiving this specialist care could be confident staff had the skills and knowledge to ensure they would be treated with respect and compassion and their dignity and comfort always considered. The service worked in partnership with other agencies to ensure people received person centred care.

The service provided was flexible in meeting people’s needs. Visit times were scheduled to suit personal requirements. People we spoke with told us if they requested a change of visit time this was arranged. Assessment of people’s needs was an on-going process which meant any changes to their care was planned for. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with these changes.

People had opportunities to raise any issue of concern or pass on compliments about the service to the manager and registered provider. People we spoke with had confidence in the registered manager to deal professionally with any complaint they raised.

People, their relatives and staff expressed their confidence in the manager and felt the agency was very well managed. Staff performance was monitored well and staff were accountable for their practice. Tele- monitoring (ringing the office when they arrived and left people’s homes) was used to make sure staff were meeting their obligation in attending to people as and when required and to ensure visits were never missed. Staff expressed job satisfaction and told us they felt valued. Incentives to raise standards in staff performance were in place and appreciated by staff.

We found there were good systems in place to assess and monitor the quality of the service, which included feedback from people using the service. Results of surveys completed showed a high satisfaction with the service people received. The service had signed the ‘Dignity In Care’ pledge, and Unison’s Ethical Care Charter and worked in partnership with other agencies to raise standards.

People were involved in their assessment of needs and the development of their care plan. People's views were taken into account and they were therefore able to influence the delivery of their service.

People were generally satisfied with the support they received with their medication. Appropriate records were maintained of the administration of medication.

Appropriate checks were undertaken when new staff started working for the service.

There were systems in place to monitor and assess the quality of the service. People were given the opportunity to complete an annual customer satisfaction questionnaire. People were aware of how they could raise any concerns and suitable arrangements were in place to respond to any complaints. None of the people spoken with had any concerns about the service.