Archived: Sanctuary Home Care Ltd - Derby

Sanctuary Home Care Ltd (Derby) provides care and support to people who reside within three locations in the Derby area which are all extra care-housing accommodation. The provider employs staff for each of the three locations who support people with their personal care and household tasks such as laundry, cooking and shopping outside of our regulatory framework. The main office is based within Greenwich Gardens, one of the extra care-housing accommodations.

We last inspected this service in June 2014 and found some breaches of legal requirements. These were in respect of the care and welfare of people who use services. During this inspection we found that improvements had been made to meet these requirements. This included improvements made to the detail and reviewing of care plans in order for staff to meet people’s needs.

The service has a registered manager. 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 using the service told us they felt safe when staff were supporting them with personal care. Staff told us they were confident that if they had any concerns about people’s safety, health or welfare then they would know what action to take, which would include reporting their concerns to the registered manager or to relevant external agencies.

Potential risks to people were assessed and used to develop plans of care.

Staff had undergone a robust recruitment process and had received training to enable them to meet people’s needs in a safe and timely manner. People’s needs were met, which included support to prepare and cook meals for themselves when required. Staff liaised with health care services and external agencies where appropriate.

People’s choices and decisions were recorded within their care records. Staff gained consent from people using the service before delivering care. Staff promoted the rights and decisions of people and were aware of the principles of the Mental Capacity Act 2005. People’s needs had been assessed prior to them receiving a service and they told us they had been involved in the development and reviewing of their plans of care.

People we spoke with were happy with the care and support they received. We received positive comments about staff from people using the service. They told us that staff were kind and caring and that their privacy and dignity was respected.

We saw appropriate information given to people using the service to ensure they knew how to raise concerns, or make a complaint. People told us they were aware of how to raise concerns. The provider had not received any complaints within the last twelve months.

There were systems in place to check the quality of the service provided. The registered manager sought regular feedback from people using the service in order to develop and improve the service. Staff told us that they were supervised and that regular staff meetings were held. They told us that communication was effective and that they felt supported by the provider.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People told us they felt safe. The relatives we spoke with also said they thought their relatives were safe with staff. People said that they felt their rights and dignity were respected by staff.

Staff had been aware about care plans and support plans had been written for people with particular needs. Some plans did not contain sufficient detail to promote people's welfare. This did not entirely promote their welfare. The manager stated that care plans would be reviewed to ensure that all people's needs were met.

Is the service effective?

People's health and care needs had been assessed and care plans had been in place. There was evidence of people being involved in assessments of their needs and planning their care.

Specialist dietary needs were assessed and included in care plans though more detail was needed in some plans to ensure people got the right food, to receive proper dementia care and have the right equipment to prevent pressure sores.

All care plans had been reviewed but some had not been reviewed regularly to ensure people's changing needs were met. There was evidence in daily records that not all people had their continence needs met.

This did not entirely confirm that all of people's needs were being met.

Is the service caring?

We spoke with 20 people. All the people we spoke with told us that staff had supported them properly. One person said 'staff could not be friendlier. They know what they are doing. You couldn't have better staff than this.'

People and their relatives said they had been sent a satisfaction survey. This meant there was an opportunity for people to comment on the service provided and whether it was caring or not.

We saw no evidence of an action plan produced from surveys. This would have helped to ensure people were not at risk of not receiving good quality care.

Is the service responsive?

Two out of 20 people said they had not been satisfied with the staff response time when they called for help. They said this meant they had to wait too long to be helped to go to the toilet. The manager swiftly followed this up with the people concerned, and said that she would monitor these situations. All the other people told us when they told management about anything that had concerned them, this had been quickly put right.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

Staff also told us that management were supportive to them and had time to answer any queries they had.

The service had some systems of a quality assurance system. We saw that staff had been spot checked to ensure care was meeting the needs of people. Staff received supervision to check their competence and provide them with support. However, there were no specific audits in place to check that specific issues were working well such as care plans, medication and staff turning up on time to provide care. This meant there was a risk that action would not be taken as quickly as needed with regard to these issues.

We spoke with 14 people who used the service and six relatives.

Most people we spoke with said they were happy with the care they received, and felt that their needs were being met. Comments from people included 'the staff are doing an excellent job; the service is unbelievable, I give the staff 10 out of 10; the staff help me to maintain my independence and dignity; the staff are friendly and helpful but they do not always visit at the allocated times.'

We found that the service was flexible and centred around people's needs. Staff respected people's privacy, dignity and independence.

People had agreed to their care and treatment. Most people found the service to be reliable, as they usually received the help they needed at their preferred times.

People liked the staff that supported them, and got on well with them. They said that they felt listened to and able to raise any concerns with the staff.

People were protected from the risk of abuse as the provider had taken steps to prevent abuse from happening.

Staff had received induction training and an appraisal of their work. However not all staff had received appropriate supervision and further training to meet people's needs.

We found that the service was effectively managed.