Background to this inspection
Updated
26 May 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
An inspection manager and an inspector attended the office. An Expert by Experience made telephone calls to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection visit because we needed to be sure the registered manager would be available to support the inspection. What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. Due to the COVID-19 pandemic and in order to minimise our time spent in the office, we requested that several documents were sent to us by e-mail. For example, policies and procedures, business and contingency plans and the staff training matrix. We spoke to four members of staff. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We visited the office on 26 April 2021 and spoke with the provider, registered manager and one team leader. We spoke with four people and four relatives. We viewed a range of records including four care plans, medicine records, safeguarding and accident and incident records. We looked at three staff files to look at recruitment processes and a variety of records about the governance of the service including files relating to auditing, complaints and compliments.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and complaints policies. We spoke to two members of staff and three professionals.
Updated
26 May 2021
About the service
Spring Care is a domiciliary care agency that provided support and personal care to older and some younger adults with a range of needs for example, those living with dementia, epilepsy and diabetes. At the time of the inspection, the service supported 52 people, 46 of whom received personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating and drinking. Where they do, we also consider any wider care provided.
People’s experience of using this service and what we found
People told us they felt safe. Staff were split into three geographic teams which meant that in most cases people had the same small team of staff supporting them. There were no reports of missed calls and a system was in place to manage when a staff member was delayed when making a care visit. Staff understood safeguarding and were able to tell us what steps they would take on identifying risks to people. Assessments were carried out to identify risks and these were regularly reviewed. Staff were recruited safely and were employed in sufficient numbers to meet all care calls and needs. Accidents and incidents had been reported, recorded and investigated with any learning being shared with all staff and steps put in place to prevent recurrence. Some people required support with their medicines and this support was provided safely by staff trained in medicine provision. Infection prevention and control measures were in place and were regularly reviewed in line with government guidelines.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Some people lived with variable mental capacity and best interest meetings had taken place. Mental capacity assessments were carried out when required. Pre-assessments of people’s identified needs for example, epilepsy and diabetes were recorded and managers were able to ensure that staff had the required training and skills to look after people. Staff received a comprehensive induction which was supported with ongoing regular supervision meetings and a full training program. Some people received support with eating and drinking. People were supported to make choices about their health and social care needs.
Staff had received training in dementia and how to support people with communication needs. Staff told us about the importance of listening to people, looking at body language and signs that they were not feeling well. A complaints policy was in place and people and relatives were confident in raising issues and concerns. Care plans provided details of discussions concerning end of life care. This was person-centred and considered all aspects of people’s needs and wishes including their faith and culture.
Everyone we spoke to, spoke well of the registered manager. People, relatives and staff all had ways of providing feedback about the service. For people, this was achieved through a regular questionnaire although people told us that they could raise any issues with the registered manager or staff at any time. Care plans were person-centred and were accessible to all staff via a mobile telephone application. This had enabled staff to quickly update themselves on recent events and care visits and managers could quickly oversee care plans, picking up any trends or alerts. The registered manager used the application to conduct audits and reviews. The registered manager was aware of their responsibilities under the duty of candour which involves telling us and the local authority about important events that affect individuals and the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (published 22 October 2019) 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 carried out an announced, focused inspection of this service on 26 April 2021. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion 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 Spring Care PAs Battle Limited 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.