Sarah Care Limited

Sarah Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of this inspection the service was supporting approximately 165 people. 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. Where they do we also consider any wider social care provided.

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

The service had a positive culture that was person-centred, open, inclusive and empowering. The service ensured that staff in all roles were highly motivated and offered care and support that was exceptionally compassionate and kind. People's human rights, equality and diversity were very important to the service. Care workers understood the importance of respecting people’s diverse needs and promoting independence. Comments included, “The personality of the carers is superb, and I love talking to them. They lift my mood up in the morning,” “They [staff] are incredibly caring and very kind,” “My sister is very happy with the care, they [staff] are brilliant. Excellent, cannot speak highly enough of them,” “They [staff] talk to him [family member]about daily current affairs. They are just really lovely people who are dedicated to their work” and “I have regular carers who are excellent. They are fantastic and I couldn’t wish for anyone better. They really do care.”

People and relatives were exceptionally complimentary about how caring the staff were. The staff valued the people they cared for. People had built, strong, meaningful and trusting relationships with staff. Staff told us they enjoyed working at the service. Comments included, “I do enjoy working for Sarah Care the job itself is great and team members and clients are too. I enjoy all aspects of my job” and “Sarah Care is a fantastic company to work for and I'm very happy with all aspects of the job. Service users are happy with the care they receive and know that confidentiality is our first priority.”

People said they felt safe using the service. Staff were aware of their responsibilities in keeping people safe. Risks to people’s health and safety were assessed and mitigated. Medicines were managed safely by the service. Medicines records had been improved since the last inspection. There were enough staff available to ensure people received their calls. Most people told us they were supported by regular care workers. The provider had safe recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

People were consulted and listened to about their care and support needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The registered managers monitored the quality of the service and took action when issues were identified. This ensured the service was safe and well managed. The service had received positive feedback from health professionals about the support provided.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 May 2019) and there was one breach 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

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook a focussed inspection to review the key questions of safe, caring and well-led only.

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 Sarah Care 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.

Sarah Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of this inspection the service was supporting approximately 125 people with personal care.

People’s experience of using this service:

• People told us they felt safe receiving care from Sarah Care Limited. People were supported to raise any concerns and they told us the service responded promptly to resolve any issues. Staff were trained in their responsibilities for safeguarding adults from abuse. This supported people to stay safe.

• Staff were trained in safe medicines administration. They administered people’s medicines in a safe way. However, we identified that improvements were required to the records maintained by the service in respect of medicines management, particularly when staff were prompting people with their medicines. Staff did not always record prompts given with individual medicines and the service did not always gather information about the medicines people were taking when staff prompted with medicines. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; good governance.

• Risks to people receiving care where assessed, however some improvements were needed in this area to ensure all risks were adequately assessed and all necessary risk reduction measures were recorded.

• People told us they usually received care from a small number of regular care workers who knew them well. They told us staff usually turned up on time, stayed for the correct length of time and provided them with all the support they needed in accordance with their preferences.

• Staff were kind and caring and were keen to deliver a person-centred service. People told us they felt well-treated and staff were respectful towards them.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's consent was obtained before care was delivered. Where people were unable to consent to their care due to a lack of capacity, relevant people were consulted about their care in accordance with the Mental Capacity Act 2005. We have made a recommendation about the service obtaining copies of Lasting Powers of Attorney granted by people using the service.

• People were supported to make decisions about their care and were involved in regular reviews to make sure it continued to meet their needs.

• Feedback was regularly obtained from people using the service, their relatives and staff via various methods. It was used to improve the service and to improve people’s experience of receiving care.

• Staff received a wide range of training which supported them to undertake their roles effectively. Staff told us they were very well supported by the registered managers and they felt the service was well-managed.

• We found there was an open, welcoming, positive culture within the service. Staff all enjoyed their jobs and the staff team communicated well and worked effectively together. People using the service told us the communication they had with the service was very good and the service was efficiently run.

• The service worked well with other organisations and this supported them to deliver effective care to people. We received positive feedback about the service from one of their commissioners prior to this inspection.

• Senior staff and the registered managers completed a range of checks on the service to monitor the quality and safety of the care provided. We found some improvements were needed to the quality assurance system to ensure it adequately identified the issues we found in the assessment of risk and recording of medicines support.

• More information is in the full report.

Rating at last inspection:

At the last inspection the service was rated good (published 21 September 2016).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Enforcement:

Please see the 'action we have told the provider to take' section at the end of the full report.

Follow up:

We will continue to monitor the intelligence we receive about this service until we return to visit as part of our re-inspection programme for those services rated requires improvement. If any concerning information is received we may inspect sooner.

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

Our inspection was discussed and arranged with the registered manager two days in advance. This was to ensure we had time to visit and contact people who used the service and speak with the registered manager and staff.

People who used the service, their relatives, staff and other interested parties spoke positively about Sarah Care. Their comments included, “Everything’s good, no problems,” “We couldn’t ask for better” and “So pleased we have this service.”

People who used the service said they felt safe whilst receiving support and care from their care workers. People looked forward to when their care worker was visiting and told us, “They are like my own family.”

Where people needed help and assistance to administer their medicines this was provided in a safe way. All staff were trained in how to administer medicines safely and people told us they always received their medicines at the appropriate times.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and the principles of the Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

There were enough staff employed to make sure all visits were carried out at the agreed time. The registered manager made sure full employment checks were completed for all staff before they were offered a position at the service.

Staff felt well supported by the registered manager and senior staff. They said they had regular meetings with their line manager’s where they were given the opportunity to discuss their work and talk about how they could improve the quality of the service.

People said they had their own regular care worker’s who knew them well and cared for them as agreed in their care plans. Each person’s care plan was updated regularly and changes made where necessary.

People told us they could talk to any of the staff at Sarah Care. They said if they had any concerns or worries they were confident staff would listen to them and look at ways of resolving their issues.

There were effective systems in place to audit, monitor and improve the quality of the service provided. Regular checks were undertaken to make sure safe procedures were adhered to. People who used the service, their relatives, staff and other interested parties had been asked their opinion via surveys. The results of these surveys identified any areas for improvement and feedback was given about any actions taken as a result of listening to people.

There were approximately 157 people who used the service at the time of the inspection. We spoke over the telephone with 20 people who used the service and with five relatives of people who used the service. We also spoke with five staff and the registered provider/manager in person.

We saw information to demonstrate how arrangements to seek people's consent to care or treatment had been agreed. People had care records which included up to date information about how they wanted their care and support provided, and they understood the care and treatment choices available to them. One person said, 'They [staff] are friendly and professional. They make sure things are right for me.'

People received safe and appropriate care because their needs were assessed before care was delivered. This ensured the provider could meet people's individual needs.

We saw records to confirm medicines were managed safely and effectively.

We found there was an effective recruitment procedure in place and relevant checks were carried out when staff were employed.

We saw that the service had provided people with information about how to complain. People who used the service told us their comments and complaints were listened to and acted upon.