This announced inspection took place on 23 and 29 November 2018. On the first day of our inspection we visited the offices used by the service; on the second day we visited people, along with their family members and friends who had agreed to meet us in their homes.Aceso Homecare is a domiciliary care agency. It provides personal care to older adults living in their own homes in the community. Not everyone using Aceso Homecare receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; which is help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection Aceso Homecare was providing personal care for 29 people. This is the first inspection of this service.
A registered manager was 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 told us that they felt safe with the care and support they received and that the service was very reliable. One person told us, “Yes; we are really pleased and I feel safe and confident with the carers.” One person’s relative told us, “The care is reliable and of good quality.” One health and social work professional told us about the service, “They are really reliable. People’s families are always pleased with them. We get really good feedback.”
The service had enough staff and organised people’s calls in a way that meant carers had sufficient time to provide people’s care and were not rushed. One person told us that the staff, “Spend any extra time they have chatting.” Staff told us that they also felt well cared for and this supported them in caring for other people. They spoke enthusiastically of having a feeling of job satisfaction after caring for and supporting people in the community.
People told us that they thought the care staff visiting them at their home were outstanding in their care and very considerate in their approach towards them. One person said, “The girls are absolutely brilliant. When they come it’s like friends coming round.” Another person told us, “I feel comfortable having them in our house. It’s really nice.” We saw examples of people’s choice being promoted in the way care and support was provided. One person’s family member told us that when the service started, “We got to say what we needed. We felt listened to and they have always been there to help us. This makes me feel comfortable asking for help from them.” Another person told us, “They [care staff] make us feel comfortable; they are polite and always ask us what we like.”
Staff had been recruited in a way that helped ensure they were safe to work with vulnerable adults. Staff working at the service received appropriate support to enable them to be effective in their roles including a schedule of training. Staff told us that they had benefitted from the training provided. One staff member told us, “The training has been really good and useful; it has helped me in my role.”
Staff told us they are happy in their roles. One staff member told us, “I love it here. It’s all about people. There is a good atmosphere amongst the team; we have a can-do approach.” Staff were enthusiastic about their roles and spoke passionately about people’s support that was going well. It was clear that people doing well was important to them.
The service prioritised keeping people safe. Staff told us there was a responsive culture that made them feel comfortable raising any concerns they may have regarding people supported. All staff received training and regular refreshment of their knowledge of safeguarding vulnerable adults.
Each person had an initial assessment of their needs that was person centred, comprehensive and focused on their preferences, desired outcomes and what they wanted to achieve. Each person also had a person centred and detailed care plan entitled, ‘Your home your care’. This included information people had chosen to share about themselves and guidance for staff on what the person wanted to achieve and the aim of the support time. People also told us that the service they received was flexible and could be changed in response to a change in their circumstances.
The service was provided in line with the principles of the Mental Capacity Act (2005). There was evidence that it was embedded practise to obtain people’s consent and views before providing any care and support and people were supported to make their own decisions.
The service had a system in place to identify, assess and safely managing risks that may arise in people’s support, whilst respecting their choices and freedom. There was a system in place to record and learn from any accidents, incidents and near misses that happened at the service; we saw that if any happened these were learnt from to help prevent them happening again in the future.
People received effective care to remain as healthy as possible. Health and social care professionals praised the effectiveness of the service in supporting people with their healthcare needs. One healthcare professional told us, “They are innovative and go above and beyond in thinking of how they can meet people’s [healthcare] needs. We are really happy with what they are doing.” We also saw that when people needed support with their medication this was done safely.
People and their families praised the quality of the service provided and the approach of staff and managers. One healthcare professional told us, “Communication with the service is excellent and feedback from people’s families [about the service] is positive.” When we asked the staff members about the leadership of the service they told us that they felt appreciated, well supported and that senior staff go above and beyond in their role when supporting staff members.
Leaders within the service had a clear vision of how to ensure that people received high quality care and support. The owners and registered manager arranged for a series of regular audits of the service to take place. This helped them to assess the quality of the service being provided. The service was also responsive to complaints and any concerns raised by people.