Coastal Care Agency

At the last inspection in January 2016 the service was rated Good. At this inspection we found the service remained Good.

People supported by the Coastal Care told us they were treated with respect, patience and kindness and reiterated they were not rushed. One person said, “This is an excellent service with caring people who don’t rush around despite limits on time. I can only say good things about them.”

Staff members said they were allocated sufficient time to visit people and undertake their duties. One staff member said, “We do spend the time we need and try not to rush.”

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 had been appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

There was a complaint system should people have concerns about the service and staff attitude, however none had been received by the agency.

The registered manager/owner had procedures in place to minimise the potential risk of abuse or unsafe care. Staff had received safeguarding training and were able to describe good practice about protecting people from potential abuse or poor practice.

Recruitment procedures remained robust to add to ensuring suitable staff were employed and keep people safe. In addition risks were identified and documented for potential risk of accidents such as the home environment staff supported people in.

Risk assessments and care records were organised and had identified the care and support people required. We found they were personalised and informative about care people received. They had been kept under review and updated annually or when changes occurred.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

Medication procedures protected people from unsafe management of their medicines. People received their medicines as prescribed and when required them. Also when staff supported people and when appropriate staff were provided with personal protective equipment to protect people and themselves from the spread of infection.

Staff rotas we were shown reviewed evidenced there were sufficient numbers and skill mixes of staff to meet people’s requirements in their home. People we spoke with said they found staff to be well trained and knowledgeable about their responsibilities. One person who received a service said, “They seem well trained and confident. I know the ones who come here are good cooks.”

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

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

When required staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals. This was confirmed by records kept by the agency and talking with people who used the service.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and staff meetings to seek their views about the service provided. They produced surveys and sent them to people’s home to complete.

Coastal Care provides domiciliary care and support to a range of people in their own homes. The range of support provided includes assistance with personal care, domestic duties, laundry tasks, shopping, and meal preparation. At the time of our inspection visit we were informed the service provided support for 37 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.

At the last inspection on 29 April 2014 the service was meeting the requirements of the regulations that were inspected at that time.

There were appropriate numbers of staff employed to support people who used the service and provide a flexible service. For example one person who used Coastal Care said, “They never let me down and are hardly ever late.”

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Records confirmed staff had received safeguarding training. We spoke with staff and they had an understanding of their responsibilities to report any abusive practices.

Staff knew the people they supported and when we spoke with staff they were aware of the people they visited and their health needs. Care plans were in place in the homes we visited detailing how people wished to be supported. People who used the service and their relatives were involved in making decisions about their care. Risk assessments were completed for staff entering private homes to ensure people were kept safe.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. 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.

Staff told us they received supervision with the registered manager on a regular basis. Records we looked at confirmed this. This meant they had opportunities to discuss any issues or training needs that would support them to provide a better service.

Training records indicated all staff responsible for assisting people with their medicines had received training. This meant they had the competency and skills required to administer medicines safely.

People were supported to eat and drink where needed. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals. This was confirmed by records kept by the agency.

We found a number of audits were in place to monitor quality assurance. The registered manager had systems in place to obtain the views of people who used the service and their relatives/friends. This was completed to ensure the service continued to develop and identify any issues that required to be addressed.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them, relatives and from looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced when using Coastal Care.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us that they felt their rights and dignity were respected. One person using the service we spoke with said, 'The staff are all courteous, polite and respectful when they come into my home, I could not do without them.'

Recruitment practices were safe and thorough. One newly recruited staff member we spoke with said, 'The procedure was very thorough, all my checks had to be in place before I started work here.' Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of support they required at home. People said their care plans were up to date and reflected their current support needs. One person said, 'They always check what needs to be done and ask if everything is ok when they come here.'

A relative we spoke with said, 'I live a long way but have had no problems with this agency. 'They provide an effective, safe service which helps mum's independence. I feel comfortable with being a long way away mum is being looked after.'

We found that there were enough skilled and experienced staff so that people had their care delivered at the right time, usually by the same people and in ways they wanted.

Is the service caring?

We spoke with people and their relatives being supported by the service. We asked them for their opinions about staff who supported them. Feedback from people was positive and comments included, 'The girls are fantastic I don't know what I would do without them. ' Also, 'They are so willing to do extra to help if needed.'

When speaking with staff it was clear they genuinely cared for people they supported. One staff member said, 'The agency is good to work for and I love visiting the clients and building relationships with them.'

People told us they had received a visit from the owner/manager of the agency before the service commenced. This was to introduce themselves and carry out an initial assessment. They told us their needs had been discussed and they had agreed with the support to be provided. Records we looked at confirmed this.

People using the service and their relatives, completed an annual satisfaction survey. The owner/manager would analyse the responses and act upon any negative comments.

Is the service responsive?

The service worked with other agencies including social services to make sure people received care and support in a coherent way. This meant people received the right care and support to remain independent in their own home.

Is the service well-led?

There were a range of audits and systems put in place in by the owner/manager to monitor the quality of the service being provided. This helped to ensure people received a quality service at all times.

We had responses from external agencies including social services .They told us they had a working relationship with the owner/manager and staff to make sure people received their care and support they required.

The provider responded by sending the Care quality commission (CQC) an action plan of how they would address the findings from the previous inspection.

We found evidence the owner/manager had addressed the concerns from the previous inspection.

We spoke with a staff member who confirmed regular formal supervision meetings were in place with the manager.

People who used the service told us the agency provided a good service. Comments included, 'We have had others but they are reliable and polite.' Also, 'The staff seem to know what they are doing which helps me and my wife.'

People told us they had received a visit from the owner of the agency before the service commenced. This was to introduce themselves and carry out an initial assessment. They told us their needs had been discussed and they had agreed with the support to be provided. They told us the staff provided sensitive and flexible personal care support and they felt well cared for.

We found that there was enough skilled and experienced staff so that people had their care delivered at the right time, usually by the same people and in ways they wanted. One person said, "What I like about the agency is they try and match the right staff for me.'

"I have worked at different agencies and this is by far the best. All the people are polite and caring."

"The staff are always on time, polite and respectful."

"It's a very good agency they provide a good service to my wife and the support given to the staff from the owner is terrific

One person we spoke with told us they were satisfied with the level of care and support they receive from the agency. Comments included, "Good staff who know how to treat people".

We spoke with five people who used the service, about their experiences being supported by the agency. They told us the staff and management provided sensitive and flexible personal care support and they felt cared for.