Archived: Cera Tamworth

Homecare4U Staffordshire is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of inspection, the service was providing support to 44 people.

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

People did not always receive personalised care that was appropriate to meet their needs. People’s call times were regularly late and inconsistent and call times were not provided in line with people’s preferences.

People were not always supported by staff who the provider had ensured received adequate training to ensure they could provide consistent care.

People were supported to have maximum choice and control of their lives and staff mostly supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not always support this practice. For example, staff did not always understand the principles of the Mental Capacity Act and the provider did not complete their own mental capacity assessments.

People’s end of life wishes were not always discussed with them if they were not at the end stage of their life so their preferences were not known.

Some actions identified by audits undertaken to check the quality of the service were not always addressed immediately. Staff told us that communication was poor and they did not always feel heard when they raised concerns.

People were safe. Systems were in place to protect people from abuse. Risks to people were identified and staff understood how to manage risks effectively. Medicines were administered safely and medicine errors were addressed appropriately when needed. People were supported by staff who used appropriate Personal Protective Equipment (PPE) and understood how to reduce the risk of infection. People were supported by safely recruited staff. When things went wrong and people’s safety was put at risk, action was taken to address this and reduce the risk of similar occurrences happening again.

People’s needs and choices were assessed and reviewed when needed. People were supported to maintain a balanced diet in line with their care plans. People were supported to access healthcare support when needed and referrals were made in a timely manner.

People were supported by kind and caring staff. People were encouraged to express their views and be involved in making their own decisions. People were encouraged to be independent and do what they could for themselves. People’s privacy and dignity was respected by staff.

People’s communication needs were considered and staff communicated with people in a way they understood. People were supported by staff who engaged and built rapport with them to try to reduce their social isolation. People’s concerns and complaints were listened to by the manager, investigated and action taken where needed.

Audit systems in place were mostly effective in checking the quality of the service. The manager understood their responsibilities and statutory notifications were submitted to CQC as required by law. People, relatives and staff were encouraged to provide feedback to improve the service. The registered manager had identified areas for learning and was taking steps to improve the quality of care provided. The service worked closely with other agencies to ensure people’s needs were met.

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

Rating at last inspection

The last rating for this service was good (published 29 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We inspected this service on 27 March 2017. This inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived. There were 60 people in receipt of personal care support at the time of this inspection visit. This was the first inspection since the provider’s registration on the 6 April 2016.

The service had 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.

People received their calls as agreed and in general from a consistent staff team. Staff supported people to make their own decisions. When people were unable to consent, assessments had been undertaken to ensure they were supported in their best interests and with the involvement of their family. The delivery of care was tailored to meet people’s individual needs and preferences.

People were protected from abuse as staff understood what constituted abuse or poor practice and their role in reporting concerns. The provider had systems and processes in place to protect people from the risk of harm. Checks on staff were done before they started work to ensure they were suitable to support people. Medicines were managed safely and people were supported to take their medicine when needed.

People were supported by staff that received training to develop their skills and safely support the people they worked with. Staff were provided with supervision by the management team to monitor their conduct and support their professional development.

People’s needs were assessed and care plans were developed with them to direct staff on how to support them in their preferred way. When needed people were supported to maintain their dietary requirements and preferences and to access healthcare services.

Quality monitoring checks were completed by the registered manager and provider and when needed action was taken to make improvements. The provider sought the opinions of people and their representatives to bring about improvements. People knew how to complain and we saw when complaints were made these were addressed. The provider understood their responsibilities around registration with us.