Archived: Junctions Care Agency Limited

There was a registered manager in post at the time of our inspection. 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.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People told us that they felt cared for safely in their own home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staff understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

People received care from staff that were compassionate, friendly and kind and who would go the extra mile to support people and their families. Staff had the skills and knowledge to provide the care and support people needed and were supported by a management team which was receptive to ideas and committed to providing a high standard of care.

There were systems in place to monitor the quality of the service provided. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to.

Below is a summary of what we found. The summary is based on evidence we collected from speaking with people who used the service, their representatives, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. One person told us, "I feel really safe with my carers. They support me when I'm at home and also when I go out." The provider had safeguarding procedures that staff understood and used. People told us that they felt their rights and dignity were respected. A person told us, "My carers help me with my personal care the way I want them to." Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. The manager had responded appropriately to concerns that staff had identified and reported. The provider's procedures and monitoring reduced the risks to people and helped the service to continually improve.

The provider had ensured that people received care and support from the same team of staff. One person told us, "I always know which carer is going to come." People told us that staff always carried out the care routines that were detailed in their care plans. Staff had received appropriate and relevant training that helped them understand the needs of the people the supported. This showed that people received the care and support they wanted and expected from staff with the right skills.

The provider had procedures in place that identified good and poor practice. Staff received refresher or additional training if their care practice had been identified as falling below expected standards. Staff also had access to written guidance and training regarding issues of capacity and the related requirements of the Mental Capacity Act.

Is the service effective?

People's care and support needs were assessed with them.. People were involved in the development of their care plans. People's plans included their aims and aspirations. Care plans were regularly monitored. This meant the provider had been able to support people to achieve their aims. People's care plans were kept up to date which meant the people's care plans reflected their current needs.

Staff had received training and support to be able to support people who used the service.

Is the service caring?

We asked one person who used the service and the relatives of the two other people for their opinions about the service. They told us that staff had carried out the care routines they expected and had supported them to be as independent as they wanted to be. Staff had either taught people new skills or helped them maintain existing skills.

We spoke with staff who demonstrated that they genuinely cared for and understood the needs of the people they supported. Staff knew what their responsibilities were in relation to identifying and reporting abuse. Staff had received training to understand what dignity-in-care meant in practice. People we spoke with told us that staff were kind and caring.

People's preferences, interests, aspirations and diverse needs had been recorded in their care plans and care and support had been provided in accordance with people's wishes. This showed that people's rights had been respected.

Is the service responsive?

People who used the service and their relatives provided feed-back about the service through three-monthly satisfaction surveys. The provider had responded to what people had said. Where shortfalls or concerns were raised these were acted upon.

People knew how to make a complaint or raise concerns if they were unhappy. Staff also knew how to raise concerns. We saw that the provider had investigated concerns and had taken appropriate action. This meant people could be assured that the provider took concerns seriously and investigated them and made improvements.

The provider worked closely with other services and agencies to make sure people received specialist support when they needed it. The provider had ensured that people had received the support of health professionals when they needed it.

Is the service well-led?

The provider had a system for monitoring the quality of service provided. This relied on direct feedback from people who used the service, their relatives and observations of staff.

Problems that had been identified through the provider's quality assurance procedures were addressed promptly. Opportunities to improve things were acted upon. As a result the quality of the service was continuously improving.

Staff we spoke with were clear about their roles and responsibilities. Staff had a good understanding of the aims of the service. Staff were supported through supervision and training and had opportunities to further develop their knowledge and skills. This helped to ensure that people received a good quality service at all times.

We looked at records which showed that people's care and support needs had been assessed, documented and reviewed. They gave staff clear guidance on how to meet people's individual needs and requirements. A relative commented, 'They [staff] did a very thorough assessment of [family member's] needs and requirements. I am really pleased and cannot fault them.'

Records showed that appropriate arrangements were in place to protect people from the risks associated with medicines.

However, we saw that effective recruitment procedures had not been operated in all cases to ensure that appropriate checks were carried out before staff began work at the service.

The provider had put an effective system in place to regularly assess and monitor the quality of service that people received.