Archived: Home Caring Services

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found -

Is the service safe?

We looked at a sample of three care records and saw each person had a care plan and risk assessment which covered their needs. We saw regular reviews of the care plans had taken place.

We saw people’s personal records were accurate and fit for purpose. However, we found staff records and other records relevant to the management of the service were not accurate and fit for purpose. For example, in one staff file we looked at we identified that a reference had not been obtained from a person’s last known employer. The manager informed us of the reasons why and the steps they had taken to assure themselves that the person was of good character. However, this risk assessment had not been documented. This meant it was not clear whether appropriate steps had been taken to obtain this reference and whether a full risk assessment had been completed prior to the person commencing employment.

Is the service effective?

People told us they were happy with the care and support they received. It was clear from speaking with staff that they had a good understanding of people’s needs. One person told us: “They are very good indeed. They listen to you.” The three relatives we spoke with told us staff understood their relatives’ needs. They also said that the service provided was flexible and their relative could change things about their care. One person said: “Staff went the extra mile.”

We spoke with the manager who informed us there were arrangements in place for people to access other services, including: GP, dentist, optician and the Community Learning Disability Team (CLDT). The manager said these services were accessed through a single point of contact due to the complex care packages the service provided. We spoke with three healthcare professionals who confirmed that people had access to other health services and professionals when needed.

Is the service caring?

All three people we spoke with told us staff understood their needs. People said they were involved in making decisions relating to their care and they could change things if they wanted to.

Is the service responsive?

People’s needs had been assessed before a support service was provided. The people and relatives we spoke with told us they were regularly asked for their feedback by the manager.

Staff told us they worked well with other providers to ensure the best possible care was given to the people who used the service. Staff confirmed people had access to relevant healthcare professionals in a timely manner. The people who used the service and three relatives told us healthcare professionals where accessed when required.

Is the service well-led?

We looked at three care records and saw these had been recently reviewed and were up to date. These reviews helped in monitoring whether care records were up to date and reflected people’s current needs so that any necessary actions could be identified at an early stage.

The computer software package that had been sourced in order to track staff recruitment, training, supervisions, spot checks and care record reviews had been uploaded with information since the last inspection. However, this system had not been actively used because the provider had just recently completed this process. Therefore we were not able to assess the effectiveness of this system. We will check this at the next inspection.

We found policies were still out of date and referred to obsolete government agencies and legislation. For example, the recruitment policy referred to the Care Standards Act. Also the complaints policy and ‘service user guide’ did not inform of a person’s right to contact the Local Government Ombudsman. The ‘service user guide’ referred to the obsolete, Commission for Social Care Inspection.

We were made aware of two complaints that had been made by a healthcare professional and a person who used the service. The person who used the service told us who was dealing with their complaint and the progress that had been made. We discussed the action that had been taken in response to the concerns raised and we were assured by the manager appropriate action had been taken. We asked for and received a summary of complaints people had made and the provider’s response. However, no complaints had been recorded.

Due to the complex needs of people who used the service we were not always able with speak to people. To help us gain an understanding of the service provided, we spoke with six relatives of people who used the service. All the relatives we spoke with gave good feedback about the service. People’s relatives made the following comments about the staff:

“They are genuinely caring and thorough. They are very good at what they do.”

“They’re lovely. They don’t rush.”

“If the carers change, they let my [relative] know.”

“They are very thorough. My [relative] has taken to the carers.”

We found people expressed their views and were involved in making decisions about their care and treatment. We spoke to a social worker and care coordinator who were happy with the care provided. One person said; “They deliver complex packages well. The service is very flexible.” Another person told us; “They manage complex and difficult packages well. They involve the clients and their families and create a good relationship.”

The provider did not have an effective recruitment and selection processes in place. We also found appropriate checks had not been completed on staff at the commencement of their employment.

Staff told us there were enough staff to meet people's needs and that they had enough time to support people in the way they wished. Both people we spoke with told us staff had enough time to spend with them.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received. The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

“On the whole, the carers are good. They know what they’re doing.”

“I wouldn’t change any of them. They are very good.”

We sought feedback from a social worker who had worked closely with the provider. They commented; “Home Caring services have never let any of the people I am involved with down, and have been very good at liaising with myself and nursing colleagues.”

We looked at three care records and found people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. However, we identified some care plans could have provided further detail in order to make it clear what people’s needs were and how those needs were to be met.

We spoke with four members of staff who were aware of the different types of abuse and described how they would respond if abuse was suspected or happening. We saw the provider reported safeguarding matters to the Local Safeguarding Authority. However, we found relevant matters were not being notified to the Care Quality Commission (CQC) as required by regulation 18 of the CQC (Registration) Regulations 2009.