Archived: Crystal Care Home Care Limited

Crystal Care is a service which delivers personal care to people in their own homes. At the time of our inspection, 100 people were using the service. The service supports older people and people with more complex and specialist support needs.

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.

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

People told us they felt the service provided safe care. Staff at the service were conscientious, well trained and professional. Infection risks were minimised by good hygiene practice. Staff supported people to take their medicines and followed clear policies around the care they provided.

People were encouraged to remain independent within their own home and family members were involved in decisions about care. People were supported to eat and drink safely and were encouraged to make their own decisions around daily care. Healthcare professionals we spoke to spoke highly of the service. A healthcare professional told us, Crystal Care had “good outcomes for some very vulnerable patients.”

Staff were caring. People were quick to tell us that staff cared about them and were polite and friendly. People told us, “The care I get is excellent.” And “They make time to chat. Always ask if I'm ok and double check if I need anything else doing.” Relatives were also happy to praise staff who worked happily and took time to talk and ensure that everything was done to people’s satisfaction.

People received personalised care plans, which were reviewed regularly. Complaints about the service were few, but when received the deputy manager dealt with them promptly. Continuous supervision by senior staff ensured people received good care. A relative told us, “If I had any worries I wouldn't be using them, so I'm happy to be totally honest.”

The service did not have a registered manager. The provider worked with the deputy manager to support staff and ensure care was received by people in a timely manner. Staff worked well with other healthcare providers to ensure good care for people. Audits and checks were carried out by senior staff to ensure continual improvements to the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 29 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crystal care Home Care on our website at www.cqc.org.uk.

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.

Crystal Care Home Care delivers personal care to people in their own homes. At the time of our inspection, 83 people were receiving the service. The service predominantly supports older people and can support people with complex and specialist support needs.

We last inspected the service on 7 August 2014 where no concerns identified

There was not a registered manager in post. 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. On the day of the inspection visit, the provider supported this manager to explain how the service operated and was managed.

People told us they felt safe with the staff that came to their home. Staff were trained in safeguarding and understood the signs of abuse and their responsibilities to keep people safe. Recruitment practices were followed that helped ensure only suitable staff were employed at the service.

Risks of harm to people were identified at the initial assessment of care and their care plans included the actions staff would take to minimise the risks. Staff understood people's needs and abilities because they had the opportunity to get to know people well through shadowing experienced staff during induction before working with them independently. Equipment used to support people was regularly tested to ensure it was safe to use

People were supported by regular members of staff who supported people in a timely manner. Staff were trained in medicines management, to ensure they knew how to support people to take their medicines safely to keep accurate records.

Staff received the training and support they needed to meet people's needs effectively. Staff felt supported by management team and were encouraged to consider their own personal development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of MCA and DoLS. People made their own decisions about their care and support. When people lacked capacity the best interest process was followed.

People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. Staff referred people to healthcare professionals for advice and support when their health needs changed.

People told us staff were kind and respected their privacy, dignity and independence. Care staff were thoughtful and recognised and respected people's wishes and preferences.

People and relatives said that the service was responsive to their needs. The service proactively assessed people’s needs so they received support when they needed it. The service worked with other providers to provide care to people so they could either stay in or return to their family home.

People received person centred care from a service that had a flexible approach and was responsive to unforeseen circumstances

People knew how to complain and were confident any complaints would be listened to and action taken to resolve them. When areas of improvement were recognised plans were put in place to resolve them.

People and relatives agreed that the service was managed well. Management understood the service being provided. Staff and management talked about the open door policy in place, which made the management team approachable.

The provider's quality monitoring system focused on the experience of people. It included asking people for their views about the quality of the service and field supervisions and observations. The computer system in place informed the management team when tasks, such as a review of care, were due. We saw that these were completed when needed.

We looked at the arrangements that had been put in place to provide formal supervision and appraisal for staff. This was now being maintained on staff files and electronically which alerts the provider when the next supervision is due.

We saw that systems were in place to monitor the quality of service being provided. This had been uplifted to a new IT system which enabled the service to undertake monthly audits and to maintain records appropriately.

Staff told us that they had received appropriate training although records did not fully substantiate this information. The registered manager told us that this was due to IT problems preventing access to training records. Also because training had not been certificated by training companies used. Though most staff felt supported by managers we found shortfalls in supervision and appraisal systems. People said they trusted staff and felt safe in their presence. Staff told us they had received safeguarding training.

Whilst the views of some people had been sought about the service received, there were not effective systems for regularly assessing and monitoring the quality and safety of services. A business continuity plan ensured that services were maintained in emergencies, also arrangements ensuring the safety and suitability of equipment.

The people we spoke with all told us that they felt the care they received was of a very high standard. One person told us "I have nothing but praise for the girls." Another person told us "They are all very kind girls who do more than enough for me."

We spoke to some relatives of the people who used the service. They told us that they had great confidence in using Crystal Care and that they felt the staff always treated their relatives with dignity and respect. We saw that people were given an information pack prior to their care starting which contained information about complaints, fees, who to contact in an emergency and details of the care package being provided.

We spoke to staff about their understanding of safeguarding and the majority of staff were able to verbalise warning signs of abuse and the procedure for reporting such issues. However, one member of staff out of the five that we spoke with told us that they had not had any training.

We found that the agency had a very thorough and robust employment procedure and we saw that all appropriate checks were undertaken before any member of staff started work at the service. We also saw that all new members of staff undertook an induction and a period of shadowing prior to taking on their own client list.