28 January 2016
During a routine inspection
The service provides a domiciliary care service for older people and people with disabilities who live in the Exeter area. At the time of this inspection there were 65 people who received personal care from the agency.
There is 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.
The management and staff team demonstrated a pride in their work. They spoke passionately about the service and how they constantly strove to provide the highest standard of care. There were many examples of small gestures of kindness that made a big difference to people. For example if a person was feeling poorly when staff visited, the staff passed this information on to the office. A member of the management team always visited or phoned the person during the day to check they were feeling better, or if they needed medical attention or an extra visit. They also demonstrated their care for people by sending each person a birthday card, and by making an extra visit to each person at Christmas with a box of mince pies.
People who used the service praised the management team and staff for their kindness and caring manner. Comments included “I can’t fault any of them – they are all nice,” and “They are all lovely.” Health and social care professionals told us they found staff to be exceptionally caring. For example, one professional told us the staff were “Very good at ‘popping in’ to people if they were concerned about them. They will ‘go the extra mile’”.
The management and staff team were constantly checking the quality of the service and seeking ways of making improvements. They sought the views of people who used the service in a variety of ways, and acted on any comments or suggestions. For example, they had recruited a receptionist in the last year which meant people were always able to contact or visit the agency during normal office hours. They had also introduced an ‘on-call’ system for out-of-hours contact.
People received a safe service. Thorough recruitment and selection procedures had been followed when recruiting new staff. They took care to make sure applicants were suitable for the post before they began working with people. Staff were well trained, well supported and were competent to meet the needs of each person who received personal care.
Staff were competent to administer medicines safely. Care plans contained information on each person’s medicines and understood the risks associated with them. Records were completed each time staff administered medicines.
People told us they felt safe, They were confident they could raise any concerns or complaints with the manager and these would be addressed satisfactorily. Comments included “Yes I feel safe. I know all the carers well and I feel safe with them.” All staff had received training and information on how to recognise the signs of abuse and how to report any concerns.
People received a reliable service from a small team of staff who visited regularly and knew them well. Timetables were sent out each week to let people know who would be visiting, and the day and the times of the visits. They told us the timetables were “Very helpful,” and “It is very helpful to know who will be visiting.” Each person had been given a leaflet about the agency which contained a photograph of every member of staff giving their names and job title. This helped people recognise the staff and get to know their names.
People told us staff arrived close to the expected times of visits. If they were running more than 15 minutes late they received a call from the office to let them know. People also told us they had never experienced a missed visit. Comments included “I have never had such good service. They put themselves out for me. They always ask if there is anything else they can do for me. Continuity is always good.”
People had been involved and consulted in drawing up and agreeing a plan of their support needs. The care plans were comprehensive, well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were regularly reviewed and updated.
People were supported to maintain good health. Staff were aware of each person’s medical needs and any risks to their health and took appropriate action promptly if they noticed any changes in a person’s health.
The provider had a range of monitoring systems in place to ensure the service ran smoothly and to identify where improvements were needed. People were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways. People were asked to complete survey forms seeking their views on all aspects of the service.