Sally and Sarah are a domiciliary care service that provides personal care and domiciliary services to people living in their own homes. The service is named after the two directors, who are very hands on and involved directly in the running of the business. The service is provided from an office based at Innovation Court, Yarm Road, Stockton, and provides services to people living within an approximate 15 mile radius of the office, including rural areas. At the time of this inspection the service employed 11 staff and provided care to 34 people. The service focuses on providing private care and does not contract with local authorities. However, they do work with the local health commissioning group to provide some ‘end of life’ care services.
The service has a registered manager, who has been registered with us in respect of this service since 2013. 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 were protected by the service’s approach to safeguarding and whistle blowing, with people who used the service telling us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management listened and acted on staff feedback.
Safe arrangements were in place for staff recruitment and enough staff were available to provide people’s care. People who used the service and their relatives told us that staff were reliable, arrived when expected and stayed the correct amount of time. Staff confirmed that they were not rushed, had time to travel between calls and provide the care people expected.
The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with delivering the person’s care. Safe systems were in place for assisting people with medicines, where this was part of their agreed care plan. However, some more detailed information about this would have been useful in some of the records we viewed. We discussed this with Sally and Sarah, and the registered manager who agreed to ensure additional detail was recorded in the relevant records.
People were cared for by staff who were appropriately supported and provided with training to help them carry out their role. People who used the service told us that their staff were competent and knew what was expected of them. Staff told us they were well supported by their management and could get help and support whenever they needed it. Management monitored staff performance during care visits, reviews and one to one discussions.
This service supports people in their own homes and only provides help with meal preparation and eating and drinking where this has been agreed as part of the person’s individual care plan. We saw that information about the help people needed with meal preparation, eating and drinking was included in people care plans where this was appropriate. Staff were able to describe people’s dietary needs and preferences to us.
We saw that people’s care records included information about people’s health and wellbeing, so that staff were aware of information that was relevant to people’s care. The staff we spoke with were aware of people’s health needs and could describe what they would do if someone was unwell or needed medical support during a care visit.
People who used the service told us that staff were caring, treated them well, respected their privacy and encouraged their independence. Staff were able to describe how they worked to maintained people’s independence, privacy and dignity.
People’s care records showed that their needs had been assessed and planned in a person centred way. People who used the service and their relatives told us that they were involved in planning and reviewing their care service. People also told us that their views were listened too and that any requested changes to their care had been made appropriately.
People who used the service had written information about the formal complaints process available in their care files. People also told us that they had been encouraged to get in touch with Sally and Sarah, or the manager, if they had any issues or concerns about their service. There had been no recent complaints about the service.
The service had an appropriate management structure and registered manager in place. People who used the service knew who Sally and Sarah and the manager were and told us that they were approachable and caring. People also confirmed that they had regular contact with Sally and Sarah or the manager, to check that they were happy with their service. Staff told us that the service was well managed and organised.
No one we spoke with during this inspection expressed any concerns about the quality of care people were receiving. However, at the time of our inspection the service did not have a regular programme of formal audits to help monitor service quality. The manager was able to describe lots of positive quality monitoring activities that were undertaken (which were confirmed by people using the service, relatives and staff), but many of these were informal and not recorded. We discuss the importance of formalising and recording these processes during our inspection.
The health and social care professionals we spoke with as part of the inspection told us that the service was reliable and professional, and that they had no concerns about the quality of people’s care.