Guardian Homecare (Blackpool)

Guardian Homecare (Blackpool) is a domiciliary care agency providing personal care to people in their own homes. The agency provides support to people living in the general community and to people living in supported living houses. People in the supported living houses receive continuous care which aims to promote their independence. The service provides support to people with a range of needs including older people and people with physical and learning disabilities. The agency operates from premises based on Amy Johnson Way in Blackpool. At the time of our inspection visit Guardian Homecare (Blackpool) supported 85 people in the community and 25 people in five supported living houses.

At our last inspection on 07 and 08 June 2016 we asked the provider to take action to make improvements because we found a breach of legal requirements. This was in relation to staff recruitment. The service was rated Good overall during the inspection. At this inspection we found the provider had made improvements to ensure they met the legal requirement. We found their recruitment procedures were safe and the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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.

We spoke with10 people supported in the community. They told us staff who visited them were polite, friendly and caring. They told us they received patient and safe care and they liked the staff who supported them. Comments received included, "I like all my carers they are all very friendly and helpful.” And, “Good time keepers, friendly and caring. I rely on their help so much.”

Four people living in two supported living houses we visited told us they were happy, safe and liked the staff who supported them. One person said, “The staff are great they look after me.”

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff 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 social needs.

The service had safe infection control procedures in place and staff had received infection control training. Staff had been provided with protective clothing such as gloves and aprons as required. This reduced the risk of cross infection.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

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 support this practice.

People's care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as people needed.

People were supported to have access to healthcare professionals and their healthcare needs had been met.

People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

The service had information with regards to support from an external advocate should this be required by people they supported.

People told us staff who visited them treated them with respect and dignity.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The service had kept a record of complaints received and these had been responded to appropriately.

The service used a variety of methods to assess and monitor the quality of the service. These included daily service meetings, quality assurance visits, satisfaction surveys and care reviews.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

Further information is in the detailed findings below.

At the last inspection on 10 January 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Guardian Homecare Blackpool is a domiciliary care agency providing personal care to people in their own homes. The service provides support to people living in the general community and to people living in supported living services. People in the supported living services receive care which aims to promote their independence. The service provides support to people with a range of needs including older people and people with physical and learning disabilities. The service operates from premises based on Amy Johnson Way in Blackpool. At the time of our inspection visit Guardian Homecare Blackpool provided services to 116 people.

There was a registered manager in place. 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.

We looked at the recruitment of three recently appointed staff members and found checks including a a Disclosure and Barring Service check (DBS), and references had been undertaken before they commenced their employment. However none of the applicants provided a full employment history on their application form. There was no evidence this had been discussed at interview or a satisfactory written explanation of the gaps sought. This was a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Newly appointed staff received induction training completed at the services office base over a five day period. This was followed by shadowing experienced colleagues until they felt safe to support people unsupervised. Staff spoken with told us the training covered everything they needed to know.

Staff 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.

We visited three houses where people were supported by the service. We saw staff had a good relationship with the people in their care. People supported in their own homes told us they were happy and liked the staff who visited them.

Staff knew the people they supported and provided a personalised service. Care plans were in place detailing how people wished their care to be delivered. People told us they had been involved in making decisions about their care.

People supported by the service told us staff who visited them were polite, reliable and professional in their approach to their work. Comments received included, “I have the same group of staff who know what they are doing.” And “I get on with my carers who are punctual.”

People we spoke with told us they felt safe. They told us they received patient and safe care and they liked the staff who supported them. They said staff were respectful, friendly and conscientious.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as they needed.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns. Where people had expressed concerns appropriate action had been quickly taken.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks, house meetings and care reviews. We found people were satisfied with the service they received.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

The manager told us questionnaires were sent out annually to clients and their carers to complete. These ask for the views on the service and how they feel it could provide a better service. The manager said, "We analyse these surveys and act upon any issues that arise to improve our service." The evidence to support this was seen, and it showed that the service had put measures in place to ensure service users were promptly informed of any changes to the carers who would be attending to their personal care. The manager explained that as the care needs of people living at home has become increasingly complex, training staff to enable them to work effectively with people was very important to the service. Specialist training to meet the particular care needs of people with certain conditions was found to be an important element of the training offered to staff, and the service has a new business plan in place which will allow staff and managers to better coordinate the two strands of the care provided. ie supported living and domiciliary care.

People who use the service told us they were happy with the support they received. One person said, "Guardian provides an excellent service. I am very happy with my carers.'

People told us they had received a visit from a representative from the agency before the service commenced. They told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for.

We also visited one of the houses where Guardian provided a supported living service. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. We observed staff treated people with respect and dignity.