Age UK Lincoln & South Lincolnshire

People’s experience of using this service: People and their relatives without exception gave positive feedback about their experience of the service and the care they received. They told us they felt very safe and secure with the staff.

People were supported by a consistent team of staff and new staff were introduced at a time and pace that worked for people. People were protected from avoidable harm and abuse by staff who could identify and report safeguarding concerns. People's medicines were administered as prescribed and this was closely monitored. Staff understood people's needs and risks to their safety. Risk assessments guided staff on how to safely meet people's needs.

There were enough skilled and experienced staff to meet people’s needs. An induction was completed by new staff. Staff received appropriate training and support to enable them to perform their roles effectively. Recruitment processes were in place and followed.

Staff were respectful and built trusting relationships with people. They supported people to maintain their dignity and independence. 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.

Staff were trained in mental capacity legislation and understood their responsibilities. They gained consent before providing care and supported people to make their own decisions and choices.

Care plans contained current and personalised information that supported staff to provide person-centred care. Staff worked with professionals and responded to their advice, to ensure people's needs were met.

People were encouraged to pursue their interests and to maintain important relationships. People had end of life care plans in place which identified their wishes.

People were confident their concerns or complaints would be addressed promptly and processes in place aided this.

The manager was committed to providing a high-quality, person-centred service. They had an open and honest approach and supported staff. The manager used audits to monitor the quality and safety of the service. They listened to people's feedback and responded to issues and concerns to continually improve 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: Good (Published 19 August 2016).

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule or sooner if we receive information of concern.

We inspected the service on 28 and 29 June 2016. The inspection was announced. At the time of our inspection 37 people were receiving care under the regulated activity the service is registered with us for.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with CQC 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.

The registered manager and staff worked together in ways which kept people at the heart of the services they provided. Staff understood what was important to each person and worked closely together with other professionals to help people to be in control of the care they received and promote their well-being. People and their relatives were involved in regular checks and reviews of their personal care plans and the arrangements in place for their support.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this area and demonstrated a clear understanding of how to support people who lacked the capacity to make some decisions for themselves.

The provider and registered manager had developed a range of clear, easy to read information to tell people about the services they provided. This information was used by people to help them decide if they wanted to use the service. The information was backed up by systems the provider had in place to ensure people’s needs were carefully assessed and any potential risks to people and staff were identified before any services commenced. When it was needed, preventive measures were put in place in order to minimise risks and staff knew how to recognise and report any additional concerns they might identify to ensure people were safe from harm.

People who needed staff assistance to take their medicines were supported safely and staff assisted people to eat and drink enough to keep them healthy whenever this was required.

The provider took a robust approach to staff recruitment and induction which ensured new care staff had the right values to work in a safe, caring and person-centred way. The registered manager worked closely with a team of two care co-ordinators in order to provide staff with regular support and supervision, including direct observation of their care practice. Staff had the knowledge and skills required to meet people’s individual needs effectively and were actively encouraged to study for and obtain nationally recognised qualifications.

Staff resources were planned and managed with great care to ensure that staff had time to meet each person’s care and support needs. Arrangements were in place which ensured staff were able to respond quickly when people needed help quickly. Staff also had the time to support to interact with people socially. People told us that staff were almost always on time and that communication about any delays or changes was always timely, clear and consistent.

The provider went above and beyond the core homecare contract arrangements they had in place together with each person in a number of different ways through the community resources they offered. People had the chance to meet each other socially to further reduce their social isolation and the service also encouraged people to retain an active presence in their local community.

The registered manager was known to everyone who used the service and provided staff with strong, values-based leadership. Staff worked together in a friendly and supportive way. Staff were proud to work for the service and felt listened to by the registered manager and provider.

The provider and registered manager were committed to the continuous improvement of the service and maintained a range of auditing and monitoring systems to ensure the care provided continued to consistently reflect people’s needs and preferences. The provider sought people’s opinions on the quality of the service and encouraged people to raise any concerns or suggestions directly with the registered manager and other senior staff.

During our inspection we visited the provider's offices and looked at people's care records, management records, and other documentation. We also spoke with nine people who used the service, the chairperson of the board of trustees, the chief executive officer for Age UK, the registered manager and nine staff members. A single inspector carried out this inspection.

The focus of our inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary which describes what we found, the records we looked at and what people who used the service and staff told us.

If you want to see the evidence supporting the summary please read the full report.

Is the service safe?

One person told us, 'I feel safe with them (staff) because they make sure I am secure when they leave my home. I have a key safe so the staff can get in and out. They always treat me gently when they give their care.'

Procedures were in place for safeguarding vulnerable adults. Staff had received training and knew what to do in the event of suspected abuse.

Information we hold showed the provider took appropriate action to report any safeguarding concerns they had identified to the local authority safeguarding team so people could be protected from abuse.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, concerns and complaints. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Staff assessed and managed potential risks together with people to identify how risks to their health and safety could be reduced.

People said that their care plans were up to date and reflected their current needs. One person we spoke with commented, 'My care started after I had a fall. They (staff) make sure I avoid anything that I can slip on and nothing is too much trouble.'

We found visits to people's homes had been undertaken on time wherever possible, staff had completed the required tasks set out in people's care records and they had stayed for the correct time. These measures contributed to people receiving a service that provided them with effective care at home.

Is the service caring?

When we asked people if the service and staff were caring we received comments ranging from, 'They are the best carers I have had. I can't fault the way they look after me, they show they care' and 'They (staff) deserve a pat on the back for the work they do' to 'My carer is like a ray of sunshine. XXX recently made me up a bowl of fruit for me, it was lovely.'

We saw that people's choices and preferences about how they wanted to be cared for at home were respected and supported by staff. When speaking with staff it was clear that they genuinely cared for the people they supported.

Is the service responsive?

We saw people were helped to have the care they needed, when they needed it. One person told us, 'They always turn up on time.' Another person said, 'They have been a bit pushed this week due to holidays but they always let me know if there are likely to be delays.'

When people had told the provider about any delays in receiving their care, immediate action was taken to address any shortfalls to ensure care was maintained.

Where changes to care needs had been identified, staff acted promptly to respond, change the care arrangements and update their records. We also found the service worked well with other agencies and services to make sure people received care in a joined up way.

We found people knew how to make a complaint if they were unhappy and informal concerns were addressed immediately. The manager confirmed although they had not received any formal complaints about their home care services, any they received would be addressed in line with their complaints policy.

Is the service well led?

One person we spoke with told us, 'The manager is accessible. I can call the offices any time and the co-ordinators are also there. I think they have the right systems in place to do a really good job.'

Staff told us they felt supported by the organisation and the management structures in place. One staff member said, 'I feel proud to work for Age UK. We have a good reputation which I want to maintain.'

The provider had a quality assurance process and systems in place. Records showed that any shortfalls identified were addressed in the right way.