Evolving Care Limited

At our last inspection of 20 May 2016, we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People’s safety was promoted by staff who implemented the guidance as detailed within people’s risk assessments and care plans. People were supported by staff that had been recruited and had checks undertaken to ensure they were suitable for their role. People’s medicine was managed safely and people received their medicine on time.

People’s needs were assessed and met by staff who were trained and regularly supervised. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were encouraged to maintain their independence.

People had differing views as to whether they were supported by a consistent group of staff, however people said staff were caring. People’s said their privacy and dignity was respected and that they were involved in the review of their care plan.

People’s care plans were personalised to reflect the individual needs of each person and the role of staff in meeting these. Concerns and complaints had been investigated and documents supported this.

Systems were in place to monitor the quality of the care being provided, which included seeking the views of those using the service and staff. A range of audits were undertaken to evidence the quality of the care and the accuracy of records used to record people’s care and support. There was an open and transparent approach to the management of the service and staff confirmed the management team were supportive.

Evolving Care is a domiciliary care service providing care and support for older and younger adults. The service specialises in the care of people with dementia, eating disorders, learning disabilities, mental health conditions, physical disabilities, sensory impairments, and people who misuse drugs and alcohol. The service’s offices are based in Leicester.

At the time of our inspection there were 23 people using the service.

The service had a registered manager. This 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 they felt safe using the service. One relative told us they found it reassuring that the staff wore uniforms and carried identification so it was easy to check they were who they said they were

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All the staff we spoke with were trained in safeguarding and knew what to do if they had concerns about the well-being of any of the people they supported.

The service employed enough staff to meet the needs of the people they supported. If people needed the support of two staff this was provided. Staff had been safely recruited to reduce the risk of unsuitable people working for the service. People told us they were satisfied with how staff supported them with their medicines.

Staff were knowledgeable about their roles and had received the training they needed to enable them to provide effective care to the people using the service. Staff had access to a wide range of up-to-date training materials. Management supported the staff to increase their skills and knowledge through training.

If people needed assistance with eating and drinking staff provided this. Staff understood people’s healthcare needs and knew how to support them to maintain good health. They also knew who to contact, including healthcare professionals, if a person appeared unwell.

People using the service and relatives told us the staff were caring and kind and treated them with dignity and respect. They said staff communicated well with them and were sensitive to the fact that the care and support took place in their own homes. They also told us that having mostly the same staff enabled them to build up trusting relationships with them.

Some people using the service had first languages other than English. This was reflected in the staff team. The service matched people with staff who spoke the same first language where possible to make communication easier.

People using the service and relatives told us the staff provided personalised care that met their needs. They said calls were usually punctual and staff stayed for their allotted time and kept records to demonstrate this. Some care plans and risk assessments lacked detail and the registered manager said she would re-write them as necessary.

The management and staff were in frequent communication with the people using the service and relatives in order to check that they were satisfied with the care and support provided. People told us staff listened to them and acted on any concerns they might have. The quality of the service was subject to continual monitoring and audit and if improvements were needed these were identified and carried out.

We also spoke with a number of people who used the service and asked them if they had discussed and agreed to their care plan. Their responses indicated to us that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Staff demonstrated they understood the concept of ensuring care plans were current and care needs accurately recorded in the care records. One member of staff explained to us: 'I read the care plan to ensure I am up to date with what has happened and if there have been any changes since my last visit.'

We spoke with a number of people who used the service and asked them if staff had sufficient time and skills to meet their needs. Their responses indicted to us people felt supported and well cared for. One person told us: 'I know my carers, they are always on time.'

Staff indicated they were very well supported. One member of staff told us: 'I received a very useful induction and have accessed a variety of training since. The management are very supportive.'

We saw evidence that the care records were reviewed on a regular basis with the people who used the service or their representatives either by a telephone review or as a face to face meeting. People's views were sort during these reviews.

The care records we reviewed contained a personalised care and support care plan which had been signed by the person who used the service. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person who used the service told us:' All the paperwork is in my home and I am happy with my care. It is what I want'.

All the people who used the service received a handbook which identified the types of abuse, guidance on what to do if concerned and what to expect from the provider once concerns had been raised. One person told us;' I do feel safe because I always have the same carers and I know them all'.

We saw evidence of an extensive induction plan. The induction programme was signed by the manager and the member of staff once completed. We also saw evidence of supervision sessions and observation spot checks. One member of staff told us:' I feel very supported. I can raise concerns and get advice even if it's minor'.

We saw evidence of monthly telephone conversations with the people who used the service. We also saw evidence of monthly and quarterly review of care plans and risk assessments of needs.