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Inspection carried out on 30 April 2019

During a routine inspection

About the service:

Unit 2N, First Floor, referred to as Carers Direct in this report, is a domiciliary care agency that was providing personal care to 25 people at the time of the inspection. It supports people with different needs and backgrounds. Including people with mobility needs, mental health needs, learning disabilities and dementia.

People’s experience of using this service:

People, relatives and staff spoke highly of Carers Direct. The service had strong person-centred values and placed people at the heart of their work. People had access to a stable staff team they knew well and achieved positive outcomes and strong relationships. Comments from people included; “I receive such a high standard of care I have nothing to complain about”, “I receive an excellent quality of care” and “I have recommended this company to a friend of mine who like me is losing her sight and she tells me she is getting good care like me from this company.”

People were fully involved in their care and their wishes respected. People’s views were sought and their consent was always gained before any care took place. People were offered as many choices as possible in ways which met their individual needs. For example, staff had created personalised picture cards to help a person communicate when they were having difficulties with verbal communication.

People’s care plans contained personalised information which detailed how they wanted their care to be delivered. Staff knew people well and expressed care and affection for them when speaking with us. All staff we spoke with were proud to work for the service and praised the high standards of care expected.

Risks to people’s health, safety and wellbeing were assessed and management plans were put in place to ensure these were reduced as much as possible. During the inspection we identified some risks assessments which had not been completed but this had not impacted on the people using the services because of their stable staff teams. The registered manager assured us these would be completed following the inspection.

People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

There was strong leadership at the service and people, relatives and staff spoke highly of the registered manager. There was a positive culture and staff felt their voices were listened to. Carers Direct was a cooperative and as such each member of staff was a member and participated in big decision making.

People were supported by kind and caring staff who worked hard to promote their independence and sense of wellbeing. We were given examples of the staff going above and beyond for people. For example, one relative said, “One morning I had nipped out and when I got back the carer was hoovering the stairs for me. I was so grateful to her. She said she uses the stairs as well as me and it was the least she could do.”

There were quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

More information is in the full report

Rating at last inspection: This service was last inspected on 5 September 2016 where it was rated good overall and in every key question. The report was published 13 October 2016.

Why we inspected: This inspection was scheduled based on the registration date of the service.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received we may inspect sooner.

Inspection carried out on 5 September 2016

During a routine inspection

Carers Direct (SW) Ltd is a not for profit business owned by its care workers. It is registered as a co-operative with the Industrial Common Ownership Movement (ICOM). Its care workers are self-employed members of this co-operative. The services provided include assistance with personal care and domestic help.

The service had 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.

This announced inspection took place on 5 and 7 September 2016 and included a visit to the office, staff interviews and visits to people in their own homes. At the time of this inspection 33 people were using the service, of which 19 were receiving support with their personal care needs. Domestic help is not regulated by us, and therefore this inspection looked at the care and support of people who received assistance with their personal care.

The service had been previously inspected in February 2014 when it was found to be non-compliant with the regulations at that time in relation to records and monitoring the quality of the service. The service provided us with an action plan detailing the steps they would take to resolve the issues. At this inspection in September 2016 we saw that improvements had been made.

People, their relatives and staff told us the service was well-led. One person said “The office is so efficient and there is always someone to talk to day or night”, and another said, “I’m very impressed with them. The office is very good.” A relative said, “Carers Direct (SW) Ltd provide a superb service.”

People told us they felt safe with the staff and when they received care. One person said, “I always feel safe and comfortable with them.” People were positive about the way staff treated them. Each person we spoke with told us their care workers were kind and compassionate. Their comments included, “They are kind, polite and respectful, I couldn’t wish for more”, and “Quite honestly they are amazing, brilliant.” Staff spoke about the people they cared for with compassion. During our visits we saw staff and people interact in a friendly way. People were pleased to see the staff and staff used people’s preferred name.

The service recruited and provided training for staff to meet each care contract. This meant people received care from the same team of care staff for the duration of their contract with the service. People told us their staff team knew them well and they provided care in a way that respected their preferences and choices. One person told us, “I receive excellent care with the same carer each time.” Although Carers Direct (SW) Ltd is a co-operative with self-employed care staff, the service recruited staff safely and we saw the necessary pre-employment checks had been carried out. The minimum contract the service provided was for one hour and staff told us they had enough time at each visit to ensure they delivered care safely. People told us they had never had a missed call, and if the staff were going to be late they always received a phone call to notify them.

Care plans were developed with each person and people told us they had received a copy. These plans described the support the person needed to manage their day to day needs and to remain as independent as possible. Staff performance was monitored through direct observation, spot checks and appraisals to ensure they were meeting people’s needs and following the guidance in people’s care plans.

Risks to people’s health, safety and well-being were assessed at the start of the service and reviewed as and when people’s needs changed. Staff were provided with information about these risks and how to support people safely. The service supported so

Inspection carried out on 26 February 2014

During a routine inspection

We inspected the service at short notice. We spoke with five people who use the service, three relatives and visited two people in their own homes. We spoke with three members of staff, the manager, administrator and training officer.

The total number of people being supported by the service was 35 with approximately 27 care staff self-employed.

We looked at key documents including care records, risk assessments, quality assurance records and other records relating to the running of the service.

People and their relatives were very complimentary of the care and staff provided. Comments included "it's just brilliant, there is nothing to compare", "it's absolutely brilliant" and "they are all very nice and always turn up on time". People were sent a rota to tell them which staff to expect at which time. People told us "I always have the same girls" and "don't need a rota - I know who's coming".

New staff employed undertook induction training and were introduced to people who use the service before they visited them on their own. Staff were knowledgeable in their understanding of hygiene requirements.

Staff told us they felt supported by the manager and felt part of a team. They told us "they are always on the end of a phone" and "you can put ideas forward".

We found that not all the records relating to the running of the business were always undertaken, accurate and complete.

Inspection carried out on 18 February 2013

During a routine inspection

On the day of our visit, this co-operative service had 16 care workers on duty, to provide care to 19 people. We spoke to three people who used the service and five staff. One person told us �The service is absolutely excellent�.

People told us that their consent was always sought before they received any care or treatment and the provider acted in accordance with their wishes. People told us that care workers were polite and respectful.

Risks to people�s health and welfare had been identified and plans were in place to protect people from these risks.

People told us that they felt safe and at ease whilst care was being delivered and that care workers respected their belongings and property. People confirmed they had been given the service�s contact details and sufficient information about the service.

We saw that background checks on staff had been undertaken prior to them being employed. These included reference checks, Criminal Records Bureau (CRB) checks and copies of documents which provided proof of their identity.

We saw that quality assurance systems were in place which enabled the provider to monitor the quality of care. We saw that confidential records were kept securely within locked cabinets and that computers were password protected.