18 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was announced. We gave the service a few days’ notice of the inspection site visit. This was because we needed to make arrangements with the provider to speak to people who used the service prior to visiting the office location. The inspection took place between 6 and 27 July 2018. On 10 July 2018 we visited the provider’s office to review care records and policies and procedures. Between 6 July and 27 July 2018 we made phone calls to people who used the service and staff.
The inspection team consisted of two inspectors and an expert-by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience had experience of homecare services.
Before the inspection we reviewed information available to us about this service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts, ‘share your experience’ forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law. We also spoke with the local authority commissioning and safeguarding teams to gain their feedback about the service.
During the inspection we spoke with 16 people who used the service and six relatives. We spoke with 11 care workers, a care co-ordinator, the registered manager and the nominated individual. We reviewed eight people’s care records and other records relating to the management of the service such as training records, rotas and audits.
18 August 2018
We inspected the service between 6 July and 27 July 2018 and the inspection was announced.
Kalcrest Care (Northern) Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to mainly older adults. At the time of the inspection, care and support was being delivered to 94 people
At the last inspection in May 2017 we rated the service requires improvement and found three breaches of regulation relating to safe care and treatment, person-centred care and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service safe well led to at least good. At this inspection we found further improvements had been made and the service was no longer in breach of any regulations.
A registered manager was in place. 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.
Overall people provided positive feedback about the service and said it had continued to improve. People said they felt safe and secure in the company of staff. Systems were in place to protect people from abuse. Risks to people’s health and safety were assessed and clear and detailed risk assessments put in place for staff to follow.
We found there were enough staff deployed to ensure people received a reliable service although people and staff said there were some issues with continuity of staff on one of the rounds. Staff were recruited safely to help ensure they were of suitable character to work with vulnerable people. Staff received a range of training and support to enable them to do their role effectively. Overall, staff said they felt well supported by the management team.
The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity to make decisions, best interest decisions were made. People were involved in care planning to the maximum extent possible.
People’s care needs were assessed and clear and detailed plans of care put in place for staff to follow. These covered meeting people’s nutritional needs. The service worked with external health professionals to ensure people’s healthcare needs were met. People said care needs were met by the service.
Whilst most people were happy with the times that staff visited, we found some improvements were needed to ensure other people received care at a consistent time each day. We made a recommendation in relation to this.
People said staff were kind and caring and treated them well. Most people received consistent care workers which helped the development of positive relationships. People’s independence was promoted by the service.
Where people raised complaints these were logged, investigated and responded to within a timely manner. People’s feedback on the quality of the service was regularly sought and any negative comments or issues acted on.
People and relatives spoke positively about the overall quality of the service. Staff said they enjoyed working for the service and felt well supported.
Systems were in place to assess, monitor and improve the service. Audits and checks were used to make positive improvements to the service.