Filipino Care Givers

Filipino Care Givers is a domiciliary care agency providing live in care and support to 25 people living in their own homes. At the time of the inspection 17 people were receiving personal care. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided

People’s experience of using this service and what we found

At the last inspection the agency did not always provide a service that was safe for people to use and staff to work in. This was because not all risks to people were assessed and monitored effectively. Recruitment procedures were not robust, and we were not assured that staff were recruited in a safe manner to keep people as safe as possible. Staff files were not fully completed and were missing some pre-employment key documents. Staff training was not consistently applied in line with the provider's training and induction policy. The governance systems did not pick up and address the shortfalls identified.

At this inspection risks to people were assessed and monitored effectively. Recruitment procedures were robust, and we were assured that staff were recruited in a safe manner to keep people as safe as possible. Staff files were fully completed including pre-employment key documents. Staff training was consistently applied in line with the provider's training and induction policy. The governance systems picked up and addressed any shortfalls identified.

The agency was a safe service for people to use and staff to work in. There were enough staff to meet people’s needs and support them appropriately. This enabled them to live in a safe way and enjoy their lives. The staff were appropriately recruited with required checks carried out. Risks to both people and staff were assessed, monitored and updated when required. The agency reported, investigated and recorded accidents, incidents and safeguarding concerns. Medicines were safely administered. The agency met shielding and social distancing rules, used Personal Protection Equipment (PPE) effectively and safely and the infection prevention and control policy was up to date.

We found and people and their relatives said the care provided was effective, they did not experience discrimination and their equality and diversity needs were met. Staff were well-trained, and appropriately supervised and appraised. People and relatives praised the way staff provided care, which met their needs well. Staff encouraged people to discuss their health needs, any changes to them and these were passed on to appropriate community-based health care professionals. The agency had a good care professional’s network that enabled seamless joined up working between services based on people’s needs, wishes and best interests. It included any required services transitioning as people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

The agency had an open, honest and positive culture with transparent management and leadership. The statement of purpose clearly defined the agency vision and values, which staff understood and followed. Staff were aware of their responsibilities and accountability and they were willing to take responsibility and report any concerns they may have. The agency reviewed service quality and made changes to improve the care and support people received. This was in a way that best suited people. The agency had well-established working partnerships that promoted people’s needs being met outside its remit to reduce social isolation. Registration requirements were met.

Rating at last inspection

The last rating for this service was requires improvement (published 30 October 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. At the last inspection risk assessments were incomplete and recruitment procedures were not always robust. Staff files were incomplete, and training was not consistently applied in line with the provider's training and induction policy. The governance systems did not pick up and address the shortfalls identified. A decision was made for us to inspect and examine the risks associated with these issues.

CQC has introduced focused/targeted inspections to follow up on previous breaches and to check specific concerns. We undertook a focused inspection approach to review the key questions of Safe, Effective and Well-led where we had specific concerns outlined above.

As no concerns were identified in relation to the key questions is the service Caring and Responsive, we decided not to inspect them. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Filipino Care Givers on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Filipino Care Givers is a domiciliary care agency providing live in care and support to 18 people living in their own homes at the time of the inspection.

12 people using the service were receiving personal care. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

We found that the provider was in breach of the regulations in relation to safe care. The agency did not always provide a service that was safe for people to use and staff to work in. This was because not all risks to people were assessed and monitored effectively. You can see the action we have told the provider to take with regard to this breach at the back of the full version of this report. The manager and staff were working hard to ensure that all risk assessments were fully up to date during the visit.

Recruitment procedures were not robust, and we were not assured that staff were recruited in a safe manner to keep people as safe as possible. Staff files were not fully completed and were missing some pre-employment key documents. You can see the action we have told the provider to take with regard to this breach at the back of the full version of this report. We have recommended the provider completes all the required checks and records them.

We found that the provider was in breach of the regulations in relation to effective care. Whilst there was some evidence provided in relation to staff training, this was not consistently applied in line with the provider’s training and induction policy. The manager was updating required training during the inspection. You can see the action we have told the provider to take with regard to this breach at the back of the full version of this report.

We found that the provider was in breach of the regulations in relation to well-led care. The governance systems did not pick up and address the shortfalls described in the safe and effective sections. You can see the action we have told the provider to take with regard to this breach at the back of the full version of this report.

The agency had an open, honest and positive culture with clear leadership and management. Its vision and values were well defined, understood by staff and followed. Areas of responsibility and accountability were identified, staff understood them and accepted responsibility on the ground and reported concerns they may have to the management. Service quality was reviewed, although it did not address shortfall areas, as described. However the agency made changes to improve the care and support people received individually, when identified, as outlined by relatives very positive comments. The IT system enabled the agency to run smoothly and improve people’s care experience, on a day to day basis. Audits were carried out, and care records updated, although this was made more difficult during the pandemic. The agency established working partnerships that promoted people’s welfare and minimised their social isolation. The agency had recently appointed a new manager who was embarking on the registration process.

Relatives said the support people received, enabled them to live safely and enjoy their lives. The agency reported, investigated and recorded accidents and incidents and safeguarding concerns. Suitable numbers of staff were available to meet people’s needs. Medicine was safely administered, by staff trained to do so.

Relatives told us they did not feel people were discriminated against and their equality and diversity needs were met. Staff were suitably supervised, and appraised.

Relatives praised the manner in which staff provided care and conducted themselves, which met people’s needs and expectations. Staff spoke to people clearly, and at a pace and in a way that they understood. Things were explained to them including their choices and options. Relatives told us that regarding people with dementia, staff were very patient and repeated information as many times as was required for them to be understood. Staff encouraged people to discuss their health needs and these were passed on to other community-based health care professionals, such as GPs as appropriate. The agency had cultivated and developed a professional network that enabled joined up working between services based on people’s needs, wishes and best interests. People were protected, by staff, from nutrition and hydration risks, and were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

Relatives were very complimentary about the way people were provided with care and support, both field staff and management. They said attention to small details made all the difference. People’s rights to privacy, dignity and confidentiality were respected by staff. They were encouraged and supported to be independent and do the things, they could, for themselves. This promoted their self-worth and improved their quality of life. The agency provided staff who were very friendly, caring, and compassionate. They were also passionate about the people they provided a service for and the way they provided it.

People received person centred care and had their needs assessed and reviewed. They were supported to follow their routines, interests and hobbies, and reminded of their choices. People were provided with suitable information to make their own decisions and end of life wishes were identified, if appropriate and adhered to. Complaints were recorded and investigated.

People were supported to have maximum choice and control of their lives staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered by us on 14 February 2019 and this is the first inspection.

Why we inspected

This inspection was prompted in part by concerns raised about the service. A decision was made for us to inspect and examine the risks associated with these issues.

Enforcement

We have identified breaches in relation to safe, effective and well-led at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. We have identified breaches of regulations that relates to assessment of risks, appropriate and timely staff training and governance.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.