Archived: Castlerock Recruitment Group Limited

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found.

The agency was providing support and care to people living in their own homes. Our inspection was carried out over a period of two days by two inspectors. The agency was providing a service to 66 services users in Warrington, Halton and the St Helens area.

Is the service safe?

We found that people had an initial assessment of their needs, a care plan and risk assessments in place. Records contained information about people's health and social care needs and daily notes showing how the care and support was delivered.

The agency had carried out a questionnaire survey in early September 2014, to obtain the opinion and views of people who used the service. One of the questions on the questionnaire form was, 'Do the carers make you feel comfortable and safe?' Over 95% of people answered 'yes'. Some of the comments were, 'Care has improved recently, but there was a late call in the last two weeks', 'I'm more than happy with everything 'and 'Happy with the care received. Good continuity of carers'.

There was an out of hours on call system in place to deal with any unforeseeable issue or emergency. There had been some reported issues recently, alleging that it was sometimes difficult to make contact with the service by telephone. We were informed that a new telephone system had been introduced and we observed that the system was much improved and the staff taking calls were expected to answer within five rings. In discussion with people using the service and with care staff, we were told that the telephone system is much better. After our inspection, one local authority contracts monitoring unit, informed us they are still having problems with contacting the service by phone and they had waited over five minutes before being put through to the person they were trying to contact.

We visited three people in their own homes and we contacted 12 other people by phone. Overall people told us they felt safe and secure with the support and care they received. Some of the comments were, 'No reason to complain', 'I am 100% happy with the carers' and 'They (agency) sent somebody a couple of times I didn't know. It's not happened again since I complained'.

We found some recent evidence of back to back calls and we saw that one call (the previous day) had been missed. This resulted in the manager making a safeguarding referral to the local authority, to be investigated.

Is the service effective?

Some of the comments received from people we visited were, 'I'm happy with the service, very good with flexibility' and 'Can't always get through on the phone'.

We spoke with the registered manager, the area manager, other senior managers and four other members of staff, who were able to demonstrate a clear understanding of people's needs and how to meet them.

People's records were securely maintained in the agency's office. Although during our inspection the manager was unable to locate all of the documents we had requested for inspection. We were eventually provided with the documents we had asked to see.

Is the service caring?

The feedback we received from people who used the service and from their relatives was positive about the level of care that had been provided.

Some of the comments were, 'I have no issues with the care, I get treated with dignity and respect', 'The carers are absolutely amazing, they need to get gold stars', 'Care has improved recently, but there was a late call in the last two weeks', 'I'm more than happy with everything ', 'Happy with the care received' and 'To me the carers are the face of Castlerock, I feel the carers are sometimes let down by the office'.

Is the service responsive?

The agency assessed people's needs before they were offered a service; this was to make sure they could meet people's individual needs. Peoples care plans contained information regarding their backgrounds or social history. Care plans also contained specific and individualised information and guidance.

We saw evidence that the agency had referred people to other services, for example we saw that one person had been referred to the Local Authority for a review of their care needs.

Is the service well-led?

The service had a manager in place that was registered with CQC. We looked at how the manager made sure that the quality of the service being provided was appropriate.

We saw that there were arrangements in place to help make sure that the quality of the service was monitored. These included an annual questionnaire survey, regular team meetings and the agency had an electric monitoring system in place, which was linked to the local authority's contract monitoring unit. This was meant to monitor the calls being provided, in order to ensure that people were receiving the correct amount of time allocated to them. We identified some back to back calls were happening. This is known as 'call cramming', which meant that care staff were not always being given sufficient travel time between calls. Therefore people using the service were not always getting the correct amount of time, that they had been assessed as needing.

We looked at the outcomes for reviewing the safeguarding of people, the outcome dealing with how the agency managed complaints and checked how members of staff were recruited, especially regarding Disclosure Barring System (DBS) previously known as CRB. We found that the system used, helped to show that people are protected and safeguarded.

We also looked to see if members of staff had the necessary skills, experience, appropriate and relevant training, which was needed to provide a satisfactory level of care and support to vulnerable people in their own homes.

We looked at how the agency managed any complaints and we checked the staffing levels for the agency.

We reviewed the compliments and some of the quality monitoring surveys, which had been returned to the agency by people who used the service and/or their relatives. Some of the comments were, 'The staff are always polite, always smart and wear their badges' and 'I get on very well with my carer'.

We saw that over 95% of the returned surveys stated that people received dignity and respect.

We observed one person being supported in performing daily life skill activities. The interaction between the member of staff and the person using the service was one of mutual understanding of the persons care and support needs. The positive interaction demonstrated that the person was encouraged to be as independent as possible.