22 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection team comprised one adult social care 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 made telephone calls to people receiving a service to discuss their experiences about the support and service they received.
Service and service type: This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
The inspection site visit and activity started on 4 February 2019 and ended on 6 February 2019. We visited the office location on 4 February 2019 to see the manager and office staff; and to review care records and policies and procedures. On 5 February we visited people being supported in their own homes alongside staff, and made phone calls to other people. On 6 February 2019 we contacted staff by phone to discuss the service, and received emails from others.
What we did:
Before the inspection we reviewed all the information we had about the service, including notifications and responses from questionnaires we had sent to people using or staff working for the service.
Prior to the inspection the registered manager had sent us a provider information return or PIR giving us information about the service and changes they had made since the last inspection. We spoke with four people in their own homes, and contacted six relatives and one person by telephone. We met, contacted by telephone or received emails from eleven staff members. On the site visit or home visits we looked at records for the service including six people’s care and support plans, risk assessments, staff recruitment records, audits and quality assurance reports.
22 March 2019
About the service:
The Care Company (SW) Ltd is a service providing care and support to people in their own home. At the time of the inspection the service was providing support to 69 people, but only 47 of those were receiving support with personal care. As the Care Quality Commission (CQC) does not regulate domestic support, this inspection relates only to people receiving the regulated activity of personal care. The service provided both regular daily visits to people in their homes and some live-in staff members, providing a 24-hour support. The service was provided across the rural area of the South Hams in Devon, and in the seaside towns of Torbay.
People’s experience of using this service:
The service was exceptional in placing people at the heart of the service and its values. It had a strong person centred and local community based ethos. Staff and the service’s management told us how important the services’ shared values were to them, and how they were passionate about providing outstanding person-centred care to people when they needed it. Many people being supported told us they thought of their carers as being like family members, and told us they were highly compassionate, caring and flexible. The registered manager told us “We have found in the past if a person feels truly cared for and included and has something to look forward to this has a great impact on their whole wellbeing.”
People’s needs and wishes were met by staff who knew them well. We saw and were told of many examples of staff going ‘above and beyond’ to help and support people they cared for. For example, we were told about how the service had supported a person living with dementia following the loss of their cat. Staff had noticed how depressed the person had become following this loss. The service had taken the person around several local cat shelters before finding the right cat for them to replace their beloved pet. The service told us this action “had a massive effect on the person’s positivity and mental wellbeing.”
Staff were safely recruited, well trained and supported with personalised training programmes and 24 hour back up. The service had a rapid response team to enable them to respond quickly to any care emergencies. Staff were aware of how to report any concerns about neglect or abuse and were confident they would be addressed. They felt they were listened to, and were part of an organisation that cared for them and their wellbeing, as well as the people they were supporting.
People were supported safely, and risks regarding their care were assessed and met. Where this was a part of their care, people’s medicines were administered safely and in accordance with the prescribing instructions. We saw staff also contacted people at times other than during visits to remind them to take certain medicines or to drink fluids.
People and their relatives told us they were treated with great respect for their dignity and privacy. We saw clear evidence of trusting, caring relationships in place, and a clear commitment to support people at difficult times with compassion, respect and affection. We heard, for example, of staff walking miles through recent snowfall to ensure people had hot meals and drinks, and staff supporting people at times of personal bereavement, giving up their own family Christmas to do so.
The service organised many community and individual activities, social events and craft days to help people avoid the risks of social isolation in the rural area where they lived. Efforts were made to ensure people had the same care staff visiting. People’s care and support plans were detailed and followed in practice. The service embraced innovation and learning to improve people’s care experiences, including working alongside other community professionals to provide ‘joined up care’ to people. Some people were being supported by technology through lifeline call systems, and MP3 players with recorded messages and personalised music in conjunction with a local charity for people living with dementia.
The leadership and management team were praised by staff and people receiving a service for their commitment and passion for care. The organisation had as a principle the need to treat staff well and reward them properly for the work they did. This had led to a positive workplace culture, with staff feeling their voice was listened to. Staff all told us the service’s management were caring and supportive and that everyone worked well as a team. Staff told us they were proud of working for the organisation, and would be happy to have them care for their own family. Systems were in place to help staff keep safe while lone working. The service had ensured resources and skilled personnel were available to support the work they did, including recruiting an HR professional, client liaison lead and dementia care champion as a part of the management team. Regular audits were carried out; people were asked their views in person and via questionnaires and changes were quickly made if issues were identified. The service learned from incidents, concerns or accidents to help prevent a reoccurrence.
More information is in the full report
Rating at last inspection: At the last inspection in July 2016 the service had been rated as good in all key questions.
Why we inspected: This was a scheduled inspection, based upon the last rating.