Absolute Care

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Absolute Care Northwest Ltd is a domiciliary care agency providing personal care to 5 people 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

Right Support: People were able to choose which staff supported them, and their preference and choices for support were assessed and reviewed. We have made a recommendation with regards to governance systems, this was because although some systems were in place, they were not always formalised.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People were supported by staff who knew them well, and were always on time for their calls. Some staff training required updating, which we highlighted with the provider and they have since taken action. People’s relatives told us they felt happy and trusted the agency caring for their family member. One relative said they were “tremendous.”

Right Culture: The provider worked as part of the team, staff said they knew the provider well, and they were always on hand to provide advice and support. All staff said the felt valued, and felt the provider cared about the people they supported.

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

Rating at last inspection

The last rating for this service was good (published 4 June 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We received concerns in relation to the management of medicines and some specialist training for staff. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remained good. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Absolute Care Northwest Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

People were protected from the risk of abuse and all the people we spoke with told us they felt safe with the staff and trusted them. One person commented, “[The staff] are like family, very trustworthy, honest, kind and caring. I’m very lucky to have them.”

People and their relatives told us that staff almost always arrived on time and always stayed for as long as they were needed. People were supported by small teams of staff who knew them well. People and staff had developed positive and well-established relationships, in some cases over many years. One relative said, “Continuity is very good, it’s one of the same three carers each time, [relative] knows them and they have a good rapport.”

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.

People told us staff were always respectful, kind and caring with them. This included respecting the fact they were visitors to people’s homes. One person said, “[The staff] are very courteous, I get on well with them.”

People and their relatives were involved in the care planning and review process. The care plans we looked at were person-centred and gave staff the information they needed to meet people’s needs. This included any religious and cultural needs. There was also good attention to detail in people’s care plans about people’s individual preferences and choices, such as the way a person liked their hot drinks and one person liked staff to switch on the heater in their bathroom before they used it.

There was a positive, caring and supportive culture amongst staff at the service and this encouraged by the registered provider’s leadership of the service. All the people and relatives told us they thought the service was well-organised and well-led. One person said, “I’m happy, [registered provider] is very approachable and she always sorts things out. She’s very adaptable and accommodating.” The service invited feedback about the quality of service it was providing, and we saw the feedback was positive. One person wrote, ‘Excellent service, reliable and caring staff’.

Rating at last inspection: At the last inspection the service was rated Good (report published 12 November 2016).

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per 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 has a registered manager who is also the registered provider and they were involved directly in the running of the business and the provision of care. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered Nominated individuals, 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 were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management listened and acted upon staff feedback.

People we spoke with who received personal care felt the staff were knowledgeable, skilled and their care and support package met their needs. People who used the service told us that they had a small team of staff, who were reliable and arrived when expected. Staff confirmed that they were not rushed and had time to provide the care people expected.

Staff told us they were supported by their management and could get help and support if they needed it. Staff did receive supervision through observations and discussions that were recorded.

The service had systems to ensure staff were appropriately recruited, trained and supported. Staff were being supported to achieve National Vocational Qualifications in health and social care.

The staff undertook the management of medicines safely and in line with people’s care plans. The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with the person’s environment and delivering the person’s care.

People and staff told us when they raised any issues they were dealt with promptly and professionally and everyone we spoke with knew how to speak to the management team at the office if they had any concerns.

There were quality assurance systems in place to gains the views of people using the service and staff would discuss developments and issues together.

The service was an active part of the local community. We saw that the registered manager and staff were committed to supporting people to remain in their own homes with support and worked with G.P’s and district nursing services and other specialist services.

The registered manager told us about how the service worked with people from different religious ethnic and religious backgrounds and supported people to uphold their beliefs and respected their traditions and religious observations.

We spoke with three relatives of people who used the service. All of the people we spoke with told us they were happy with the care and treatment their relative received. One person told us; "I can't fault them." Another person commented; "Staff are lovely and do a great job. They actually come early."

We spoke with a relative following our inspection, this person told us that staff were punctual and reliable and the quality of the service was excellent. We also asked relatives of people who used the service if they felt confident to raise any concerns they had about their care and support. People we spoke to told us they would speak to staff should they have any concerns.