12 July 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 29 and 30 May 2018 and was announced. The inspection was announced so we could ensure the nominated individual was available to meet with us. The inspection team consisted of a lead inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience telephoned a sample of people and their relatives to check they were happy with their care.
Before the inspection we reviewed information we kept about the service and previous inspection reports. This included notifications of incidents. A notification is information about important events which the service is required to send us by law. We also reviewed the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service.
During the inspection we used a range of methods to help us make our judgements. This included
talking to people using the service, speaking with staff members, pathway tracking (reading people’s care plans, and other records kept about them), and reviewed other records about how the service was managed.
We looked at a range of records including six care plans, six personnel files, and other records about the management of the service.
Before, during and after the inspection we communicated with twelve people who used the service and six people’s relatives. We also spoke with three staff members.
12 July 2018
We inspected this service on 29 May and 30 May 2018. The inspection was announced because we wanted to ensure a manager was available to meet with us. At the last inspection, in February 2016, the service was rated Good. At this inspection we have rated the service as ‘Good.’
Caresta Limited (trading as West Cornwall Care), provides people with personal care in their own homes. At the time of the inspection the service provided support for approximately 38 people for people in the Penzance, St Ives, Hayle and St Just in Penwith areas. The service works primarily with elderly people.
The service had a registered manager. 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. However a manager had recently been appointed, and an application had been submitted for the person to be registered with the Care Quality Commission. This was in order to meet its conditions of registration.
The service had satisfactory safeguarding policies and procedures to keep people safe. Staff were trained to recognise abuse, and what to do if they suspected abuse was occurring. Suitable risk assessment procedures were in place, and risk assessments were regularly reviewed. Where appropriate management and staff had submitted safeguarding referrals to the local authority.
Recruitment checks for new staff were satisfactory. For example, the registered provider obtained a Disclosure and Barring Service check and written reference check when the member of staff was recruited. When staff started to work at the agency they were required to complete a staff induction programme, which included relevant training which assisted the member of staff to carry out their job. The registered provider had a suitable system of staff supervision and annual appraisal.
Medicines procedures were safe, and we saw evidence that supported this, including administration records and systems to support people with medicines. Staff were trained in procedures to minimise the risk of infection. People and their relatives said staff were always well presented in thieir individual roles.. Staff said they were provided with disposable gloves and aprons to support them in their roles.
There were satisfactory procedures to assess people to check they were suitable to receive support from the service. Subsequently staff developed comprehensive care plans for people and these were regularly reviewed.
Where people received support to prepare meals. Procedures to monitor food eaten and fluid intake, if and where necessary, were satisfactory.
Where people lacked mental capacity, the agency provided people with the correct support to ensure their rights were protected.
Staff worked with people to maximise their independence. We received positive support about staff attitudes. Comments included; “They are very good,” “They are excellent, “ “I love them they are all very accommodating.”
The service had a complaints procedure. People said they would approach staff or management if they had a concern. People told us where they had raised concerns or complaints these had been managed sensitively and resolved appropriately.
Management were viewed positively by the people who used the service and staff who we contacted.
The staff team told us they worked well together. People and their relatives viewed staff positively and staff were viewed as caring.
Quality assurance processes were satisfactory to monitor the service was working effectively, and pick up and address shortfalls in service provision.