Archived: The Local Care Agency

The Local Care Agency provides domiciliary services to people who require support in their own home. Care is provided to a wide range of people in the community and also provides assistance for carers. The service operates seven days a week and has out of hours contacts.

People’s experience of using this service:

People and relatives told us they felt safe whilst using the service. A relative commented, “They make sure [my relative] is secure in her home and they look after her safety.” Staff files we looked at confirmed staff had safeguarding training to protect people from poor care or abuse.

The management team had good procedures to monitor and reduce accidents and incidents. Care plans we reviewed included control measures intended to mitigate the risk of unsafe support.

Personnel files evidenced the management team used the same safe recruitment procedures we found at our last inspection. Staff confirmed there were sufficient staffing levels because they had time to complete visits in a calm and unhurried way.

Staff demonstrated a good understanding of their duties to prompt people who lived in their own homes to take their medication. This assisted them to protect people from the unsafe management of medicines.

We found the registered manager was referencing current legislation, standards and evidence-based guidance to achieve effective outcomes. Staff told us training provision gave them the skills to complete their duties.

Where nutritional support formed part of a person’s care package, we saw the management team had guided staff to meet their needs.

People who used the service and relatives stated staff engaged with other organisations to help provide consistent care. We found care plans focused on maintaining their independence in all aspects of their support.

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.

We observed staff were kind, friendly and patient with people they supported. Those who used the service and their relatives said staff had a caring attitude. One person told us, “Nothing is too much trouble, they go the extra mile.”

Care records were personalised to the individual’s needs and support requirements. Information collected was used to develop agreed support packages with the person or their representative’s consent.

Staff told us the management team worked with them to gain insight into people’s support. They said the registered manager was approachable and listened to their comments. One staff member stated, “The managers are lovely. They work with us and are supportive and approachable.”

The management team regularly completed service quality assurance audits to check everyone’s safety and wellbeing. People who used The Local Care Agency told us they felt included in service development.

Rating at last inspection: Good (report published 24 September 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme or if any issues or concerns are identified.

At the last inspection on 29 August 2013 the service was meeting the requirements of the regulations that were inspected at that time.

The Local Care Agency is a domiciliary care service, providing personal care to people in their own homes within the Fleetwood and Poulton areas. The service provides support to people living in the general community and to people living in a supported living service. People in the supported living service receive care which aims to promote their independence. Support is provided to a wide range of people in the community, and also provides assistance for carers. The service operates seven days a week, and has out of hours contacts. At the time of our inspection visit The Local Care Agency provided services to 58 people.

There was a registered manager 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.

People supported by the service in the community told us staff who visited them were polite, reliable and professional in their approach to their work. Comments received included, “I have never been let down in the ten years I have been with them. They always send someone else if my regular girl gets held up.” And, “I am happy with all my girls. They know my routine and are polite and friendly with me. I haven’t a bad word to say about any of them.”

Two people who lived in a supported living house told us they were very happy with their support. One person said, “The staff are excellent. They listen and give me the help I need when I ask for it.”

People we spoke with told us they felt safe. They told us they received patient and safe care and they liked the staff who supported them. They said staff were respectful, friendly and conscientious. One person said, “I know all my girls by name. They are all lovely and will do anything for me.”

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.

Newly appointed staff received induction training completed at the services office base. This was followed by shadowing experienced colleagues until they felt safe to support people unsupervised. During the first day of our inspection visit we observed one recently appointed staff member completing their induction training at the services office.

Staff received training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

We looked at how the service was staffed. Three staff members spoken with said they were happy with how their visits were managed. They told us they were allocated sufficient time to be able to provide support people required. Ten people supported by the service told us staff were reliable and very rarely late. One person said, “My girls turn up dead on time and stay with me for the time allocated. They are never in a rush.”

Staff spoken with told us they felt well supported and enjoyed working for the service. When we undertook our inspection visit formal supervision sessions had recently been introduced and we saw records confirming staff had attended these.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people during delivery of their care. These had been kept under review and were relevant to the care provided.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as they needed.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns. Where people had expressed concerns appropriate action had been quickly taken.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks, house meetings and care reviews. We found people were satisfied with the service they received.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

People who used the agency told us they provided a good service. Comments included, 'The staff are very good. They go over and above sometimes'.

People told us they had received a visit from senior staff before the service commenced. This was to introduce themselves and carry out an initial assessment. People told us their needs had been discussed and they had agreed with the support to be provided. One relative spoken with said, 'If we need more support they are very good at organising it for us'.

We found that there were enough skilled and experienced staff so that people had their care delivered at the right time, usually by the same people and in ways they wanted. One person who used the service said, 'The staff know what they are doing. I have confidence in them'.