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This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Outstanding

Updated 6 December 2017

The inspection took place over three days on the 25 and 27 September and the 3 October 2017. The inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be present in the office. One adult social care inspector undertook the inspection.

St Luke’s Care first registered with The Care Quality Commission on the 5 September 2015. The service was last inspected on 16 July 2014 and was rated as Good overall. On the 1 July 2016 the service moved to a new location and this is the first inspection since the provider registered at the new address.

St Luke’s Care is a domiciliary care service, which provides care and support to adults of all ages in their own homes. The service provides short and long term support with people’s personal care needs in Plymouth and South West Devon. As well as support with personal care the service also supports people with other daily living tasks and activities. At the time of the inspection 19 people were receiving support with personal care needs.

A registered manager was employed to manage the service. 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 and relatives without exception spoke very highly of the service they received from St Luke’s Care. They described the staff as extremely caring and said they were always willing to go the extra mile to help ensure they were comfortable and safe. A relative we met said, “I didn’t know what proper care was like until we started using St Luke’s Care”

Relatives of people who used the service described how staff had formed strong bonds with their loved ones, which had enabled the staff to gain a deep understanding of their needs. This had helped them trust staff to provide care. One relative said, “I haven’t been able to go out, not even to the shop, now I can trust [….] is safe. I can have a little break, cut the grass, pop and get the paper” Another relative said, “ [….] has been in hospital and has been very clear that whatever I do I must have St Luke’s Care supporting them when they come home. They don’t want anyone else”. One person told us, “It’s the little things that make all the difference, they pick up fish and chips for me once a week and make sure I have fresh bread”.

People and relatives said they also felt the leadership of the service was exceptional. Comments from people and relatives included, “We know all the managers, we speak to them regularly and they visit us to check everything is ok” and “If ever I have any problem I call the office and they sort it straight away” One person described how the staff and management went over and above their role to help them when they had a crisis at home, “They sorted out accommodation for us, made phone calls and made sure the care continued, they couldn’t do enough to help”.

The management of the service inspired staff to provide a quality service. The PIR stated, ‘We have an employee of the month award which staff vote for other care staff. This has proved to be a success as everyone celebrates the positives in each other’ A staff member said “ I really believe the way we are treated impacts positively on the people we care for, we feel valued, so we value the work and support we provide”.

There was a very effective quality assurance system in place to check quality and to drive continuous improvement across the service. On the day of the inspection the registered manager was able to provide evidence of a really clear system of quality checks, analyses and action plans to address any issues relating to people’s care and quality of the service. The registered manager and senior staff undertook a range of quality audits, which included spot visits of staff, checks of all records and discussions with people to check care was being delivered in the way they needed and wanted. Information gathered about people and the service was used to aid learning and drive improvement across the service. Learning from quality audits, incidents, concerns and complaints were used effectively to help drive continuous improvement across the service.

Personalised care was central to the home’s philosophy and staff demonstrated they understood this by talking to us about how they met people’s care and support needs. Staff spoke with compassion and used words like, “Individual”, “Independence” and “Rights” when they talked about people they supported. There was a very positive culture within the service. The management team provided strong leadership and led by example. The registered manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared by the staff team. Staff had clearly adopted the same ethos and eagerness and this showed in the way they cared for people. We observed positive and compassionate interactions between staff and the people they supported. Staff said they loved their work and were passionate about providing a high standard of care.

People said the time keeping of staff for visits was good and if staff were delayed they would always receive a phone call from the head office to let them know. People said they knew the staff well and always knew who would be visiting them and providing support. Comments included, “We get a rota every week, if there is any change they let us know in good time” and “ We always know who is coming, staff might be new, but they always come with another staff member to meet us first”.

People said they felt safe using the service. A relative said, “There are always the correct number of staff available, they know how to use the equipment and support [….] in a way that makes them feel safe. I can tell they feel safe by the way they laugh and smile when they are being supported”. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated. The recruitment process of new staff was robust and people who used the service met new staff to check they were happy to receive care from them. Systems were in place to help ensure people had safe and appropriate support to manage their medicines.

Staff were well trained and said training was relevant to their role and kept updated. The registered manager was passionate about developing the skills of the team, and also kept themselves updated with current issues and best practice. Individual staff members were nominated champions in particular areas of care such as ‘dementia care’, ‘end of life’ and ‘medicines management’. They attended training and used their skills and knowledge to support staff and help ensure the whole staff team had the skills and knowledge needed to provide high quality care. The registered manager and staff worked in partnership with other agencies to help ensure the best outcome for people using the service.

Management and staff understood their role with the regards to the Mental Capacity Act (2005). People’s consent was sought before care and support was provided. When people were unable to consent to aspects of their care, or were unable to make decisions, discussions took place with relatives and other relevant agencies to help ensure decisions were made in people’s best interest.

People’s health and dietary needs were well met. Staff ensured people had access to the food and fluid they needed to maintain good health. If concerns were highlighted by staff, advice was sought by staff and appropriate referrals made to health services. Staff supported people if required to arrange and attend hospital and GP appointments.

People were involved in planning and making decisions about their care and support. Support plans were personalised and included information about people’s daily routines and how they chose and preferred to be supported. The registered manager and senior staff visited people in their homes and spoke regularly with people to check they were happy with the care provided. Support plans were reviewed regularly to help ensure information remained accurate and up to date. Annual satisfaction surveys were sent to people and relatives to provide the opportunity for feedback. This information was analysed by the registered manager and action taken to address any issues or shortfalls in the service. A monthly newsletter was sent out to people to update them on information about the service.

Inspection areas

Safe

Good

Updated 6 December 2017

The service was safe.

People told us they felt safe using the service. Relatives told us they trusted the staff supported their loved ones safely and protected their home and belongings.

People were protected by staff who knew how to recognise and report signs of possible abuse.

People were protected by safe recruitment practices and staff were employed and organised in sufficient numbers to meet people’s need and to keep them safe.

People were supported with their medicines in a safe way by staff who had been sufficiently trained.

Effective

Good

Updated 6 December 2017

The service was effective.

People received support from staff who knew them well and had the knowledge and skills to meet their needs.

People received care from staff who were well supported in their role.

People received support from staff who had a good understanding of the mental capacity act and who promoted their choice and independence whenever possible.

People’s dietary and health needs were understood and promoted by the staff supporting them.

Caring

Outstanding

Updated 6 December 2017

The service was extremely caring.

People and their relatives were overwhelmingly positive about the things staff did to show they cared.

Staff were kind and compassionate and built strong relationships based on trust with people and their relatives.

Staff showed a deep respect for people’s privacy and dignity and always respected people’s home and personal belongings.

People’s individual daily routines, communication methods and choices were well known and respected by staff. This helped ensure people were able to be involved in decisions that affected them.

Responsive

Good

Updated 6 December 2017

The service was responsive.

People’s support plans were written to reflect their individual needs and preferences, and were regularly reviewed and updated.

People received personalised care and support, which was responsive to their changing needs, requests and personal circumstances.

People were involved in the planning of their care and their views and wishes were listened to and acted on.

People knew how to make a complaint and raise any concerns. The service took these issues seriously and acted on them in a timely manner.

Well-led

Outstanding

Updated 6 December 2017

The service was exceptionally well-led.

People said the service was very well-led. People were placed at the heart of the service and were supported to be involved in decisions about how they received their care and support.

The registered manager and staff were committed to providing outstanding, personalised care. There was a strong emphasis on continually striving to improve and develop the service.

The management team provided strong leadership and led by example and had created a positive culture within the service. People were supported by staff who were passionate about enhancing people’s well-being and quality of life.

There were clear values and vision for the service, which included involvement, compassion, dignity, respect and independence. The management team monitored staff performance to ensure they displayed these values whilst supporting people.

The service was an important part of its community and developed community links to help ensure people’s continued to receive good care as they moved between services or as their needs changed. This included striving for excellence through liaison with other health and social care services, training and reflective practice.

Systems to assess and monitor the quality of the service were well developed. There were clear lines of accountability within the management team in relation to monitoring performance and quality. Auditing systems operated to help develop and drive improvement across the service.