Zephyr Care Limited

Zephyr Care Limited is a Home Instead Senior Care franchise holder. They provide personal care to people living in their own homes. At the time of our visit, they were providing personal care to six people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Risk assessments were designed to keep people and staff safe while allowing people to develop and maintain their independence. However, we noted some risk assessments could be more comprehensive. People said they felt safe and would talk to staff if they had concerns. Staff demonstrated good understanding of the service’s safeguarding policy and knew how to ensure people were protected from abuse. People were protected from the risks of unsafe or inappropriate care. There were systems in place to make sure people received their medicines safely. Background checks had been carried out on staff to ensure they were suitable to work with vulnerable people. There were sufficient numbers of staff to meet people’s needs.

People were supported to have their nutritional needs met and there was guidance in care records as to how to meet these. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice. Staff were supported through training, supervision and appraisals. They felt supported to carry out their roles. We have made a recommendation about end of life training.

People received individualised care that met their needs. They were supported to attend health and medical appointments, and staff sought medical assistance when people were unwell. The service worked in partnership with other health professionals to ensure people received effective care and support.

People and relatives told us they were satisfied with the care and support provided by the service. They said the staff were caring and treated people with respect and dignity. They felt able to make a complaint and were confident that complaints would be listened to and acted on.

People, relatives and staff spoke positively about the service and said it was managed well. There were systems in place to manage, monitor the quality of the service provided. The management team had regular contact with people using the service and their representatives. They welcomed suggestions on how they could develop the services and make improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated good (published 25 January 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The service was last inspected in July 2014 when it was found to be compliant with the outcomes inspected.

Zephyr Care Limited is a Home Instead Senior Care franchise holder. They provide personal care to people in their own homes. At the time of our inspection they were providing personal care to 12 people. They were also providing domestic assistance and companionship services to other people.

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.

The service involved people and their relatives in assessing their needs and planning their care. Following feedback that care plans and risk assessments lacked the level of detail required to ensure care was delivered in a safe and effective way the provider updated care plans and risk assessments. The updated care plans and risk assessments were personalised and contained sufficient information to inform staff how to support people in a safe way that met their needs and preferences. This included the safe management of medicines where this was required by people.

The service followed safe recruitment practice and ensured they had sufficient staff to meet people’s needs. The service established teams of care-givers around each person so they would receive care from care-givers they knew. People and relatives spoke highly of their care-givers and strong, positive relationships had formed between people and their care-givers. Care-givers understood the intimacy of care provision and told us how they supported people to uphold their dignity.

Where required by people the service supported them in a sensitive way with meal preparation and ensured they ate and drank sufficient amounts to maintain a balanced diet. People were supported to access healthcare services as required.

People signed to indicate their consent to their care. Where people lacked capacity to consent to their care the service did not have sufficient records about who was legally able to make decisions on their behalf. Staff we spoke with had not heard of the Mental Capacity Act (2005) and so did not understand how it applied to their work. We have made a recommendation about understanding and using the Mental Capacity Act.

The service regularly sought feedback from people and their relatives and made changes in response to the feedback received. The service had a robust complaints policy and people knew how to raise any concerns they had about the quality of the service.

People, relatives and staff all spoke highly of the management of the service. The service had signed up to various best practice commitments and the registered manager and nominated individual demonstrated a commitment to providing a high quality service. The registered manager completed regular audits of the service and completed actions to continuously improve the quality of the service.

Staff told us they felt supported and valued by the provider. They received sufficient training and support to ensure they had the knowledge and skills required to perform their roles. The provider operated an incentive scheme where two staff members were recognised for their contribution as employee of the month.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe?

We found the provider carried out assessments of people's care needs which were reflected in their care plans. We saw there were risk assessments of people's homes to ensure that care could be delivered safely. The manager and staff who we spoke with told us that staff wore their identity badges when visiting people at home and people we spoke with confirmed this was the case. We saw from staff records that identity badges were updated on an annual basis and a copy kept on file. There were arrangements in place to deal with foreseeable emergencies. Each person had emergency contact telephone numbers on file and information about what to do if staff were unable to gain access to their home.

Is the service effective?

The manager told us they introduced care staff to people before they started to use the service and this meant that people could tell staff how they wanted their service delivered. This was confirmed by staff and people we spoke with. One staff member told us that when they are given a new person to work with 'the manager introduces us to the person so we can have a bit of a chat before we start working with them.' Another staff member we spoke with told us 'We get instructions before we first go in and by working with them and talking to them we get to know what they need.'

Is the service caring?

People we spoke with and family members told us staff are caring. A relative told us 'the staff are caring and we are very pleased with the service.' One person told us 'nothing is ever a problem, they always find a solution', and a social worker told us 'they are very person-centred and I've seen them turn lives around for the better.'

Is the service responsive?

The manager told us staff could contact the management team during office hours for advice and guidance and there was an on call telephone number for staff to use for emergencies in the evenings and weekends. Staff we spoke with confirmed this and one staff member told us that when they had contacted the manager about a situation, 'it was resolved and everything was sorted.' The manager told us they had a procedure of introducing a team of staff to people so that there was cover if a staff member could not work.

Is the service well-led?

The service had a manager who was in the process of becoming registered. We found the provider had an office on the premises to give support to the manager when needed. People we spoke with, their representatives and staff gave positive feedback about the manager. A social worker told us the provider 'communicated extremely well' with them and kept them updated with any changes or concerns. A staff member said about the manager 'she is quite good about any problem and we can rely on her.' A relative we spoke with told us the provider was 'really accessible in terms of contact and they will take the time to come to the home to discuss anything.' We saw there were systems in place to monitor the quality of the service and this included managers observing the work practice of staff.

People and their relatives told us they were asked for their consent before any care was provided. One person said 'They always ask permission and do what you want done.'

We found that people had assessments and care plans in place and care was provided in accordance with these. People told us they were happy with the care provided. Relatives said the agency 'know and understand my relative well and are very attentive to her needs. Their quality is excellent' and 'The carers look after him so well.'

People and their relatives told us the agency worked well with other providers. One relative said "they take other providers' advice into account." We found evidence of this in care plans.

We found the service had taken appropriate precautions to reduce the risk of infection. We observed staff using protective clothing and found evidence of training in food hygiene.

People and their relatives told us they felt staff were suitably skilled and experienced. We found appropriate checks and recruitment processes had taken place.

Records were accurate, fit for purpose and appropriately stored.

We found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There was documentary evidence people were risk assessed when they received care from the service. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One care worker told us "when I go to see a client I will always look at the care plan."

We found the service had a safeguarding policy in place and care workers were trained to recognise the different forms abuse and the signs associated with them.

There was documentary evidence staff were supported in their roles. We found staff had an induction when they first started work with the agency and received training relevant to their roles and responsibilities. We found evidence staff had received a supervision and appraisal. However we found supervisions needed to be done regularly and consistently.

We found the provider had a system in place to receive and respond to complaints.