Archived: First Call Community Systems Limited Also known as T/A Surecare (York)

First Call Community Systems Limited is a domiciliary care agency (DCA) providing care and support to adults and younger adults who may be living with dementia, a learning disability or autistic spectrum disorder, mental health issues, a physical disability or sensory impairment. At the time of our inspection there were 31 people using the service. The service provides personal care, for example, assistance with washing and dressing and also provides domestic help, including shopping and assisting with housework, to people living in their own homes in York.

This service applied to change the location address of its York office in autumn 2014, but has been in operation for several years. This is the first comprehensive rated inspection at the location.

The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for the last four months. The registered manager was supported by an area manager during the inspection, because of this.

A registered manager is a person who has registered with the Care Quality Commission (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.

People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Workers were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were managed and reduced so that people avoided injury of harm.

The office premises were safely maintained and there was evidence to show that maintenance contracts were in place. Staffing numbers were sufficient to meet people’s need and we saw that rosters reflected the times and frequency of calls that people required, as recorded in their support packages. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people. We found that the support provided to people that used the service with their medication was safely carried out.

We saw that people were supported by qualified and competent workers that were regularly supervised and who received appraisals regarding their personal performance. People’s mental capacity was appropriately assessed and their rights were protected within the framework of appropriate legislation if necessary. Employees of the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. When people were assessed as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interests. The registered manager made appropriate referrals to the Court of Protection in these cases. However, this had not been necessary for some time.

People received support with adequate nutrition and hydration to maintain their health and wellbeing, if this was a requirement of their support package. We found that people received compassionate care from kind workers, that knew about people’s needs and preferences. We found that people were always asked for their consent before workers undertook care and support tasks.

People’s wellbeing, privacy, dignity and independence were monitored and respected and workers aimed to maintain these wherever possible. This ensured people were respected, that they felt satisfied and were encouraged to keep control over their lives.

We saw that people were supported according to their person-centred support plans, which reflected their needs well and which were regularly reviewed. People were encouraged to maintain good family connections and support networks. There was an effective complaint procedure in place and people were able to have complaints investigated without bias.

The service was well-led and people had the benefit of this because the culture and the management style of the service were positive and progressive. There was an effective system in place for checking the quality of the service using audits, satisfaction surveys and meetings.

People that used the service had opportunities to make their views known through direct discussion with the registered provider or workers and through more formal complaint and quality monitoring formats. They were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in their homes or in the agency office.

Our inspector visited the service and the information they collected helped answer three of our five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with staff and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Recruitment processes were in place and followed. This meant checks were undertaken to ensure people were protected from harm.

Is the service effective?

Not applicable.

Is the service caring?

Not applicable

Is the service responsive?

Not applicable.

Is the service well-led?

Not applicable.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

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

Is the service safe?

People told us they felt safe in the care of their support workers. People's rights and dignity were respected and their views were taken into account when care was planned and agreed.

People were safe because staff knew what to do when any safeguarding concerns were raised with them.

People and their belongings were safe because the service assessed and managed any potential risks like moving and handling management or risks posed by the environment.

The provider did not have a robust recruitment process to ensure only suitably vetted people worked for the service. This could pose a risk to people. We have told the provider to address this.

Is the service effective?

People were consulted and included in decisions taken about their care. This meant people's needs, wishes and choices were known.

People were encouraged and helped to comment on the service and how it was operating. Regular checks were completed to ensure people were still receiving the care and support that they wanted.

Staff had effective support and training so they could provide care safely and appropriately.

Is the service caring?

People were treated with kindness and compassion and their dignity was respected. One person told us 'I'm very pleased with the carers. They're very kind to my relative.' Another told us 'They always talk to my relative and explain what they're doing, even though they (my relative) can't respond.' One person who used the service told us 'I don't have to tell them (the support workers) what to do. They just seem to know.'

Is the service responsive?

People were encouraged to make their views known about the care and support they wanted and needed.

Support staff communicated well with the office team so that any changes or concerns could be promptly looked into. People we spoke with knew how to raise concerns and told us they were confident these would be taken seriously.

Is the service well-led?

The newly appointed general manager had made changes to improve the way the service operates. The provider promotes an open culture and the support staff spoken with said the office-based team were supportive and available for them.

The provider had ensured senior managers were regularly available to give the manager support and guidance to learn about her new role.

Quality assurance systems were in place, though some of these needed to be sustained and built on.