Archived: Purple Balm Exeter Branch

Purple Balm (Exeter) domiciliary care agency is a domiciliary care agency which provides personal care to vulnerable adults in the community, the majority living in the Exeter area. The service provision varies from half hourly visits daily to the provision of 24 hour care for people living in their own home. The agency also provides staff to work in residential and other social care settings; however we did not inspect this aspect of the service as there is no requirement for it to be registered. The registered manager told us personal care support was currently being provided to approximately 60 people.

There was 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.

The registered manager was accessible and approachable. Staff, people who used the service and relatives felt able to speak with the manager and provide feedback on the service. There were systems in place to monitor the quality of the service, including regular spot checks, audits and annual satisfaction surveys for people who used the service and staff.

Comprehensive risk assessments had been carried out, however, this was in a tick box format which did not always include detailed guidance for staff to minimise the risks. Despite this lack of detailed information, people told us staff were well informed about any risks and how to keep them safe, and no accidents or incidents had been documented in people’s homes.

Some care plans had not been reviewed to reflect changes in people’s support needs, although staff had been kept informed via an update sheet in the persons file, and emails, texts and phone calls. People confirmed staff had a good understanding of their needs and were well informed about the care to be provided. Plans were in place to review the risk assessment process and complete outstanding care plan reviews once a new operations manager had been appointed.

People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. The majority of people had a consistent staff team. The agency ensured people were notified promptly of any changes, so they always knew who would be coming and when.

The registered manager told us the service had been through a challenging time related to the retention of some management staff. This had impacted on the frequency of staff supervision. The registered manager ensured staff continued to be well supported, and staff confirmed this was the case. They received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People told us they liked the staff and looked forward to the staff coming to their homes. Comments included, “I can’t say anything wrong about them. They are really, really lovely people, they do listen to you,” and, “I’d recommend them to everybody. They’ve got time for you; they do exactly what you want them to do. They cheer you up as well. We have a chat about things and a bit of a laugh”.

Where required people were supported, as part of their care package, to access food and drink and maintain their nutrition and hydration according to their needs and preferences.

We were told by people using the service that most of their health care appointments were co-ordinated by themselves or their relatives. However, staff were available to support people to access appointments if needed and liaise with health and social care professionals involved in their care if their health or support needs changed.

The registered manager and staff team were proactive in keeping their knowledge and skills up to date and using this knowledge to improve the lives of the people they supported. They were also working to develop constructive links with the community by raising money for charities.

During our inspection we spoke with five people using the service, thirteen staff including the operations manager and the manager who is a registered nurse and is currently applying to become the registered Manager for Purple Balm Exeter Branch. We also spoke with two people who were either relatives or partners of people receiving care from the agency. All people spoke about the services they received in a positive way and were complimentary about the care workers who supported them. One person told us, "They are brilliant. I can't fault them at all. They are fantastic and the office is good too.' whilst another said 'I couldn't wish for better staff. They can't do enough for you.'

People who received a service told us they were treated with dignity and told us they were asked about what care they needed and how it should be delivered. We saw that people had been consulted about their needs and preferences and this was recorded in their care plans. Care plans were routinely reviewed and there was a system to record when reviews were due.

We saw all staff received training relevant to their role, including training in safeguarding the vulnerable person and infection prevention and control. During our inspection, staff were undertaking training in moving and handling, health and safety and safeguarding the vulnerable person. These training sessions were being held in the training room within the offices.

The provider routinely monitored and audited the services they provided and regularly sought the views of people using the service. We saw how the provider gathered people's views and undertook spot checks to ensure their staff were giving the right care and support to people.

During our inspection we spoke with nine people using the service, ten staff including the registered manager and nursing manager. We also spoke with four people who were either relatives or partners of people receiving care from the agency. All people spoke positively about the services they received. One person told us, 'They are such supportive and caring staff' whilst another said, 'The staff are excellent and have specialist knowledge'.

People told us they were treated with dignity and told us they were asked about what care they needed and how it should be delivered. This approach supported people's care and welfare needs and enabled people to receive care in the way their care plans described.

We saw that staff received training which reduced the risk of vulnerable people being neglected or abused and observed safe working practices throughout our inspection. Staff recruitment met the requirements of the providers' policy and ensured that people were checked before they commenced employment.

The provider routinely monitored and audited the services they provided and was sensitive in the way they responded to complaints.