Background to this inspection
Updated
13 October 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 7 & 8 September 2016. The service received short notice in advance of the inspection. This was in accordance with our current methodology for inspecting domiciliary care services.
The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with eight people who used the service, two relatives, four members of care staff, the operational manager and the provider. We received comments from two professionals associated with the service. We also inspected a range of records. These included three care plans, three staff files, training records, quality surveys, meeting minutes and the services policies and procedures.
Updated
13 October 2016
Sunshine Care provides a ‘live in’ personal care and support service to people in the South West of England. At the time of our inspection the team of fifty seven care staff was providing support to approximately thirty four people with a range of personal, healthcare and domestic services.
The service is required to have a registered manager and at the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.
People told us they felt safe and were well cared for by Sunshine Care. Their comments included; “I feel safe with them,” and “Oh yes the carers are like family.” Family members were generally positive about the support their relatives received. They said, “They know the job backwards. It’s been excellent.” Another commented, “We have monthly carers working two weeks and then a replacement. Not a problem with staffing so far.”
People told us that due to the agency changing to live in care meant there was no chance of missed visits or staff being late. One person said, “It’s the best thing the agency did.” The operational manager told us this approach was continuing to be developed but that it was working well and could be managed more effectively than daily calls.
A few people told us communication had been difficult on occasions due to some staff not having English as their first language. One person said this had recently improved. Another person said they had informed the agency of their concerns. The agency was asked about this and said all staff had to have an acceptable level of English but agreed to look into the concern.
The registered manager was confident about the action to take if they had any safeguarding concerns and had liaised with the safeguarding teams as appropriate. Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence. Staff told us they had attended both classroom training and e-learning (computer based training) to learn what action to take should staff witness or suspect abusive practice.
The recruitment process was safe and ensured all new staff had undergone suitable checks to ensure they were safe to work with people who may be vulnerable. The service was actively recruiting more staff to improve the flexibility in staffing levels.
Staff received a four day classroom induction based on familiarisation of the organisations policies and procedures, health and safety and practical learning including moving and handling, use of equipment and first aid. A staff member told us they had completed the care certificate induction standards so they felt competent in delivering care and support. They said, “They (managers) are good at making sure we are up to date with the training.”
People said staff were well trained and understood how to meet their specific care needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. A staff member told us, “I have the training I need to carry out my role.”
Staff received regular supervisions and annual performance appraisals. In addition ‘spot checks’ by managers were used regularly to confirm each member of staff was providing appropriate standards of care and support.
Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people needed to be supported. The service had risk assessment procedures in place. This was held at the person’s own home as well as a copy being available at head office so this could be monitored.
Suitable medicine procedures were in place should the agency be required to administer medicines. Staff told us they had received training which gave them confidence to support people with medicines safely. Regular auditing of medicine records meant errors were identified and acted upon quickly.
The management team had systems in place to regularly measure the service’s performance and look at ways of developing the quality of service they provided. There were processes in place to seek people's views on the service and monitor the quality of the service. Information from customer surveys and the actions the provider took were shared openly and honestly with people.