Care Plus Care (UK) Limited

At this inspection we found the service continued to be rated as ‘Good’. The rating is based on an aggregation of the ratings awarded for all five key questions.

Care Plus Care (UK) Limited is a domiciliary care agency that is registered to provide ‘personal care’ to people who live in their own homes within the local authority of North Lincolnshire. It provides a service to people in Barton-on-Humber and the surrounding villages. There were 56 people receiving the service when we inspected.

The provider was required to have a registered manager in post. 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. On the day of the inspection there was a manager that was registered and had been in post for the last three and a half years.

People were protected from the risk of harm and staff were trained in and knowledgeable about safeguarding people from abuse. Risk was safely managed. Recruitment of staff followed safe practices to ensure staff were ‘suitable’ to care for and support vulnerable people. Staffing numbers were sufficient to meet people’s needs. The management of medicines was safe and systems in place demonstrated there was a safe audit trail for handling all drugs. Staff followed good hygiene for safe control of infections. These measures protected people from harm.

Systems in place acknowledged and recorded when things went wrong and lessons were learnt to ensure problems or mistakes were not repeated. Staff encouraged people to make choices and decisions wherever possible in order to exercise control over their lives. People were cared for and supported by qualified and competent staff who were themselves regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity of people and met their individual needs. People’s nutrition and hydration needs were met to support their health and wellbeing.

People’s mental capacity was appropriately assessed and their rights were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff 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. The registered manager followed the ‘best interests’ route where people lacked capacity to make their own decisions. Consent for support to take place was respected so that staff always sought people’s cooperation and agreement before completing any support tasks.

People were cared for with compassion by kind staff who knew about people’s needs and preferences. People were involved in their care and had their right to express views respected. The management team set good examples to the staff team with regard to attitude and approach, which meant staff had good role models to follow. Wellbeing, privacy, dignity and independence were respected. This ensured people they felt satisfied and were enabled to make choices regarding their lives.

Person-centred care plans laid the foundations for good care. They reflected people’s needs well and were regularly reviewed. People were encouraged to maintain family connections and support networks and their communication needs were assessed and met. An effective complaint procedure in place ensured people’s complaints were investigated without bias. The service sensitively managed people’s needs with regard to end of life preferences, wishes and care.

The provider met the regulation on quality assurance and systems used were effective. Audits, satisfaction surveys, meetings, and spot checks on staff ensured there was effective monitoring of service delivery. Culture was person-centred, open, inclusive and empowering and ensured good outcomes for people. The registered manager understood their responsibilities and practiced a management style that was open, inclusive and approachable. The registered manager strove for continuous learning and good practice at every opportunity. The service fostered good partnerships with other agencies and organisations.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, and 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?

The service is safe. People felt safe because their rights and dignity were respected by the staff. People told us they felt safe. Members of staff understood their roles in safeguarding people from abuse. Members of staff understood the service's policy on the Mental Capacity Act 2005.

The service had risk management processes in place and staff supported people to take positive risks to promote their independence.

Recruitment processes were safe and thorough. People were supported by staff that had been checked with the Disclosure and Barring Service and whose references had been checked before they started work.

Processes and training was in place to ensure people received their medication safely.

Is the service is effective?

The service is effective. People were able to express their views about their health and care needs. People were involved in the assessment of their needs and care plans reflected their choices and preferences. Staff supported people to be as independent as possible.

People and their relatives were involved in discussions about their care plans. People's identified needs were monitored regularly and effectively.

Is the service caring?

The service is caring. People told us they were cared for by staff who showed patience and encouragement.

Staff knew the people they cared for and understood their preferences and personal histories.

Policies and procedures were in place to ensure staff understood how to respect people's privacy and dignity.

People were encouraged to make their views known about their care and treatment and these views were respected.

Is the service responsive?

The service is responsive. Members of staff actively listened and acted on people's views and decisions. People were given the information at the time they needed it. People's capacity to make their own decisions was considered under the Mental Capacity Act 2005.

Concerns and complaints were encouraged. People were made aware of how to complain.

Is the service well led?

The service is well led. There were effective systems in place to continually review safeguarding concerns and people's levels of care.

The registered manager had systems in place to monitor and assess the quality of the service provided to people. Where gaps or shortcomings had been identified the registered manager took swift action to address the issues.

Members of staff were clear about their roles and responsibilities. Staff were motivated, well trained, supported, and open. They acted in caring way. The registered manager understood their responsibilities and was supported by a supervisor to deliver what was required.

The premises were easily accessible and well maintained. Confidential files were stored safely.

Staff were recruited safely and checks were made to ensure people were not exposed to staff who should not be working with vulnerable people.

Staff received training to meet the needs of the people who used the service. People we spoke with were complementary about the capability of the staff. Comments included, 'The staff are really good they care for me really well', 'I enjoy my visits the staff are very friendly' and 'All the staff are well trained, they care for (name of person withheld) very well.'

Although people told us they were involved with their care and saw the manager regularly the provider did not have formal recording systems in place which regularly assessed and audited the quality of the service provided.

People told us they were 'very happy' with the service that was provided. Relatives told us that staff listened and involved people in making decisions about their support to ensure that individual preferences could be met. Relatives told us that staff demonstrated 'care and consideration' for people that used the service and that personal choices and wishes were respected about how support was delivered.

People told us told us that staff were punctual and reliable when making their visits and that this was delivered by a consistent set of carers. One person told us that staff were "spot on" and that communication with them and the office was good. One person told us they were "over the moon' with the quality service provided, whist another said some staff were better than others, but that prompt action was taken by the office to remedy concerns once any issues were made known.

We found that records were maintained of the support that was delivered and needed. People confirmed that reviews of their support were carried out and they were aware of the complaints procedure and how to use it, if it was required.