Archived: Care Sisters Limited

We spoke with the registered manager and one member of care staff. We looked at one set of records for the only person who used the service, the manager's and staff's training records, the service's satisfaction survey, policies and procedures. We spoke with one relative of the person who used the service. There were issues of non-compliance from the last inspection on the 28 November 2013 which we had received an action plan from the provider. That non-compliance was checked during this scheduled visit.

During this inspection, the inspector focused on answering our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the person who used the service was protected from the risk of abuse because staff were trained in the safeguarding of vulnerable adults and in the principles of the Mental Capacity Act 2005. We found risk assessments with clear action plans were in place to ensure the person remained safe. Their consent to care and treatment was sought appropriately. Staff monitored people's health and referred to health professionals or alerted emergency services when necessary.

Is the service effective?

The relative spoken with told us they were very satisfied with the quality of care that had been delivered. We looked at person's assessment of needs and support plans and we checked with people's family that the delivery of care was in line with their care plans and assessed needs. We found that the person's needs were re-assessed when needed and that their care plans were adjusted to reflect changes in needs. We found that the staff had received the training they required to meet the needs of people who used the service and that additional training was available.

Is the service caring?

We found that the person who used the service was supported by a kind and attentive member of staff. The relative of the person who used the service that we spoke with was complimentary about the care worker' and their approach and attitude.

Is the service responsive?

The person's needs had been assessed before care and support began and their care plans were reviewed regularly to reflect any change of needs. We saw that the person's care plans included their history, wishes and preferences. The person and/or their representatives were involved with the reviews of their care plans. The person's views were sought about the quality of care that they received and their views were to be taken into account. A relative of a person who used the service told us, "The communication is good, we are kept informed of any changes". A member of staff told us, 'I can raise my concerns and know it will be acted on straight away'.

Is the service well-led?

We found that the registered manager had a system of quality assurance in place to identify how to improve the service. The person and their relatives had been regularly consulted about their level of satisfaction and survey questionnaires were provided, they are due to be returned soon and analysed by the manager. Staff's practice was regularly observed and monitored to check good care practice was maintained and regular supervision was documented and identified whether additional training or refresher courses were needed.

One person who used the service said, 'The service is absolutely spot on, I am well looked after and am very happy'.

We looked at people's care records which had been discussed with the person who received the service and their relative when appropriate. The relative we spoke with told us that they had agreed to the care provided, and that the plan had been followed.

The person who received the service said that she was always treated with respect, and that she was asked before the care worker did anything.

The care plans viewed were detailed however there were no initial assessment or risk assessments available.

We saw the agencies safeguarding policy and the manager understood the need to keep people safe. However, the staff had not received up to date training and the agency did not have a copy of the local authority protocols.

Staff had not received training since they started work with the agency and there were no certificates on staff files to show what courses if any they had undertaken elsewhere. The recruitment procedure was not robust as references had not always been requested from previous employers; all staff did have a DBS police check before they started work with vulnerable people.

The manager did not have any systems in place to monitor the quality of the care provision.

We saw the complaints procedure, and this is part of the statement of purpose that is given to people as part of the welcome pack.