Archived: City Care

City Care is a domiciliary care agency providing personal care and support to people living in their own homes. 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. At the time of inspection 210 people were receiving personal care.

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

People and their relatives were very complementary about the service and the support provided by staff. Relatives told us how much a positive effect the staff had on people. One relative commented, “From [Person’s name]’s point of view, the carers have improved her quality of life. She has more interaction, physically she is better… it means she can stay in her own home, which is where she wants to be. I cannot praise them enough.”

Staff provided care and support to people which made them feel safe. Relatives told us staff were kind and caring with people. Staff knew people well and worked together to provide a continuous level of care. People were treated respectfully by staff.

People were encouraged to remain independent within their own homes. People were supported to access the local community and staff provided social interaction to remove the risk of isolation. Staff provided people with choices about their care and involved relatives with this.

Staff encouraged and supported people to have maximum choice and control of their lives, including supporting people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Medicines continued to be managed safely. Risks to people had been fully assessed and mitigated. Care needs were assessed regularly, and people were consulted and involved in all aspects of their care. Staff continued to be recruited safely

Staff received regular training, supervisions and team meetings. There were enough staff to safely support people. Staff had their competencies checked regularly and were provided with an induction when they joined the service. People (where required) were supported to eat a balanced diet. People were referred and supported to access other healthcare professionals including their GP.

The registered manager and office staff were working on continuously improving the service provided. There were quality assurance systems in place to monitor the quality of care provided to people. This system was being reviewed to make sure all audits of the service were fully effective to drive improvement.

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 good (published 31 August 2016).

There was also an inspection on 17 January 2019. However, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This was a planned re-inspection because of the issue highlighted above.

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.

City Care is a domiciliary care agency which provides personal care and support to people in their own homes who have a variety of needs. The service is managed from an office located in Sunderland. At the time of this inspection 130 people were using 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 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 using the service told us they felt safe when regular staff supported them. Some people had regular teams of care staff. This made them feel confident in the staff that supported them. Other people said they did not know which care staff would visit them and were not always told if they were going to be late.

Some people told us staff rotas sometimes created difficulties, for example when calls overlapped and people didn’t receive the full amount of allocated time. One person said, “Sometimes they can be in a bit of a hurry.” Other people told us rotas were fine and they received their allotted time. One person said, “They take their time. They don’t rush and they take their time to get me to bed.”

Most people and relatives we spoke with felt there were enough staff to carry out visits, and spoke positively about the service. One person said, “I have good carers. I get on with everybody, nothing is a bother.” Another person told us, “I’ve never had a person who I haven’t got on with. They are friends which is a great thing."

Staff received training in safeguarding vulnerable adults, and told us about their obligations should any concerns arise. Staff said they felt any concerns they had would be taken seriously. Safeguarding concerns, accidents and incidents were recorded and dealt with appropriately. They were also analysed so lessons could be learnt to prevent recurrence.

Staff had the knowledge and skills they needed to carry out their roles and responsibilities, so people received effective care. Staff completed an induction programme before providing care, and completed additional training at regular intervals.

Staff received supervisions and observations every three months and an annual appraisal which incorporated a personal development plan. Notes of supervisions contained good detail around what staff enjoyed about their job, feedback from managers and feedback from people who used the service.

People and relatives told us staff were caring and listened to what people wanted and needed. People said they had positive relationships with care staff. One person said, “They couldn’t be more helpful if they tried.” Another person told us, “The staff look after me well and we get on. Staff take me shopping and out for lunch. I like all the staff.”

Staff had access to clear guidance about how to provide care and support to people, according to their individual needs and wishes. This guidance was set out in people’s care plans which were reviewed and updated when people’s needs changed.

Each person had a service user guide which contained the provider’s statement of purpose and complaints policy in their care plan, which was kept in their home.

People’s views about the service were sought by senior managers via telephone calls every three months. Comments from recent telephone feedback included, ‘I’m happy with the service provided,’ ‘I’m happy with all the staff who look after me’ and ‘It has not been necessary to complain in five years.’

The provider ensured the quality of the service was assessed and monitored by carrying out regular audits of all aspects of the care provided.

Staff told us they felt supported by the management team and felt able to voice any concerns they may have. Staff told us there was a positive and open culture at the service.

We found that people received the care and support that they needed and the service provided safe and appropriate care because individual needs were established before people started using the service. One person told us 'Everything was agreed with us.'

The manager had systems in place to regularly check the quality of the care and people's comments and complaints were listened to and acted on effectively.

Staff were fully supported to meet people's needs because they received regular supervision sessions and training. One person told us 'I couldn't wish for better people to be looking after me.'