We carried out a review of the data available to us about Border Cottage Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Border Cottage Care, you can give feedback on this service.
Border Cottage Care is a domiciliary care agency, providing personal care to 50 people in their own homes at the time of the inspection.
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
People felt safe and trusted the staff who cared for them. Staff understood how to keep people safe and risk management plans were detailed. Staff knew individual risks and felt confident to care for people safely.
Staff felt very well supported through regular training and supervision. People thought staff had the right approach and skills to care for their needs. There was clear communication and effective teamwork within the organisation.
People enjoyed consistent person-centred care from respectful, reliable, compassionate and caring staff.
Regular staff worked with individual people to provide person-centred care within secure professional relationships.
Staff were highly valued and cared about as individuals and there was an open friendly and transparent culture in the service. The service was well managed and the provider empowered and trusted staff to work to a very high standard of care, supporting people in individual and personalised ways. Systems and processes were in place to assess and monitor the quality of the service and the management team was responsive to feedback which enabled them to drive improvement.
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. Records demonstrated people’s choice, although they needed to be strengthened around best interest decision making.
We made recommendations around the recording and auditing of medicines and the recording of decisions made in people’s best interests.
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 Good (report published 6 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Border Cottage Care is a domiciliary care service which provides personal care to people within their own homes who have a variety of needs, including physical disabilities, sensory impairment, mental health, dementia and learning disabilities. Care is provided to older people and also young adults. The registered provider's office is based in Castleford and provides are and support to people in surrounding areas. At the time of this inspection there were 90 people who used the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider's, they are ‘registered persons’. Registered person's have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about the different types of abuse and what actions they would take if they suspected abuse was taking place. No safeguarding alerts had been made but the registered provider was knowledgeable about when an alert would need to be raised.
Risk assessments were in place for people who needed them and were specific to people's needs. These had been regularly reviewed and updated when required.
Robust recruitment procedures were in place and appropriate checks had been made before employment commenced. New staff attended a thorough induction process including shadowing an experienced member of staff before working in the community.
The service had policies and procedures in place to ensure medicines were managed safely. Accurate records were kept to show when medicines had been administered, the use of topical medicines was not always recorded.
Staff performance was monitored and recorded through a system of regular supervisions and appraisals. Staff had received up to date training to support them to carry out their roles safely. Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005.
Where appropriate, staff supported people to enjoy a good diet and suitable food and nutrition which was reported in daily visit reports. People were supported to maintain good health and had access to healthcare professionals and services when needed.
People and relatives were actively involved in care planning and decision making, which was evident in signed care plans. Information on advocacy services was available.
People spoke highly of the service and the staff. They were treated with dignity and respect.
Care plans detailed people's needs, wishes and preferences and were person centred which meant they received personalised support. Care plans had been reviewed and updated when required.
The service had a clear process for handling complaints. There had been four recorded complaints made to the registered provider in the past 12 months. These had been investigated in line with the registered provider’s policy and we could see appropriate action had been taken by the registered manager.
Staff described a positive culture that focused on the people using the service. They felt supported by the management. Staff told us that all managers were approachable and they felt confident that they would deal with any issues raised.
Staff were kept informed about the operation of the service through regular staff meetings. They were given the opportunity to recognise and suggest areas for improvement.
Quality assurance processes were in place and completed by the registered manager and operations manager. The registered providers also visited the service regularly to monitor the quality of the service although these visits were not always recorded.
Accidents and incidents were fully recorded and appropriate actions were taken to reduce the risks.
The registered manager understood their role and responsibilities. Notifications had been submitted to CQC in a timely manner.
Below is the summary of what we found but if you want to see the evidence supporting our summary please read our full report. The summary is based on speaking with people who used the service, the staff supporting them, our observations and from looking at records.
Is the service safe?
People told us they were treated with dignity and their rights were respected. One person said, 'The girls are lovely, polite, kind, they would do anything for me; they are great.'
The Registered Manager had a number of different measures in place to check that systems were safe and working effectively. This included audits on daily notes, care plans, risk assessments and medication administration.
People who used the service told us they felt safe. Safeguarding policies and procedures were robust and staff understood their role in safeguarding the people they supported.
Rotas were planned to suit the needs of the people who used the service. Staff and the Registered Manager told us they could be flexible in arranging and re-arranging times to suit people who used the service.
Recruitment practice was safe and thorough. Policies and procedures were in place to ensure any unsafe practice would be identified and people protected.
Is the service effective?
People who used the service were asked about their care and able to make decisions. People who used the service said they were always asked for their consent before care tasks were carried out. One person said, 'They always ask what I want doing before they start.'
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spoke with seven people who used the service or their relative. People said they were aware of their care and support plans or those of their family member. They said they had agreed them when they had first started using the service. There were written contracts in place regarding what people who used the service could expect.
Is the service caring?
People who used the service told us they were happy with the care and support received. They said the standards of care provided were high. Their comments included:
'This is a very good service, all good carers, no problems at all.'
'Absolutely brilliant service, can't fault them at all.'
Staff demonstrated a very good knowledge of people's care, support needs and routines. They could describe individual care needs provided for people who used the service. It was clear they knew people well and genuinely cared for people and their welfare.
Is the service responsive?
People who used the service told us they knew how to complain or raise concerns if they had any.
Others told us the service was responsive and flexible to their needs, for example, changing call times if they had appointments or social events to attend.
Is the service well led?
The Provider had an effective system to regularly assess and monitor the quality of service that people received.
All the feedback records we looked at showed people were happy with the service and any suggestions for change had been acted upon. The Provider took account of complaints and comments to improve the service. We looked at records of complaints made and saw these were responded to and investigated properly.
Staff said they felt the service was well managed and the Provider and Registered Manager was approachable. They said they had confidence in them and that any issues brought to their attention were always dealt with properly and thoroughly.