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One 2 One Private Care Services Good

Reports


Inspection carried out on 9 January 2019

During a routine inspection

This comprehensive inspection took place on 9 and 10 January 2019 and was announced.

One 2 One Private Care Services provides personal care for 8 people. The service provides personal care to adults who want to remain independent in their own home in the community.

At our last inspection in June 2016 we rated the service Good. At this inspection we found 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.

At this inspection we found the service remained Good.

The service was not required to have a registered manager and was managed on a day to day basis by the provider. People continued to be protected from abuse. Staff understood how to identify and report concerns. Medicines were managed safely, and people received their medicines when they needed them.

Peoples’ care met their needs. Care plans continued to accurately reflect people’s needs. Risks were assessed and there were mitigations in place to minimise risk and keep people safe. Where people needed support to eat and drink or access healthcare this was provided, and staff knew how to keep people safe.

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. Staff were aware of people’s decisions and respected their choices.

There continued to be sufficient numbers of staff who had the skills and knowledge they needed to support people. Staff were appropriately supervised and supported. New staff had been recruited safely and pre-employment checks had been carried out.

People were treated with kindness and compassion. People’s privacy was respected, and they were supported to maintain their independence. People were encouraged to be involved in their own care and were involved in developing their own care plans. There were systems in place to seek feedback from people and their relatives to improve the service. People and their relatives told us that they were listened too.

Staff and relatives told us the service was well-led and that they had a positive relationship with the provider. The service was regularly audited to identify where improvements were needed, and actions were taken.

Where things had gone wrong incidents were recorded, investigated and acted upon. Lessons learnt were shared and trends were analysed. The service worked in partnership with other agencies to develop and share best practice.

Further information is in the detailed findings below.

Inspection carried out on 23 June 2016

During a routine inspection

The inspection took place on 23 and 24 June 2016, and was an announced inspection. The provider was given 48 hours’ notice of the inspection. The previous inspection on 28 and 29 April 2015 found a breach in records, relating to care planning and risk assessments, and a further breach in relation to staff training, supervision and appraisals, both breaches had been addressed.

One 2 One Private Care Services provides care and support to adults in their own homes. It provides a service mainly to older people and some younger adults and people who have a learning disability. At the time of the inspection it provided a personal care service to 7 people. They provided short visits to people and would provide 24 hour care to support people if required. The service provided care and support to people in Ashford and surrounding areas.

The service does not require a registered manager as the provider manages the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 managed their own medicines. Staff were applying creams as part of personal care routines and proper records were maintained.

Risks associated with people’s care and support had been assessed. Guidance had been improved to ensure people were kept safe.

People and their relatives were involved in the initial assessment and the planning of their care and support. Care plans contained information about people’s wishes and preferences. They detailed people’s skills in relation to tasks and what support they required from staff, in order that their independence was maintained. Care plans were reviewed periodically and reflected people’s current needs.

People felt safe using the service and when staff were in their homes. The service had safeguarding procedures in place. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

People had their needs met by sufficient numbers of staff. People’s visits were allocated permanently to staff rotas and these were only changed when staff were on leave. People received a service from a very small team of staff. New staff underwent an induction programme, which included relevant training and shadowing senior staff, until they were competent to work on their own. Staff received training appropriate to their role and most staff had gained qualifications in health and social care.

People told us their consent was gained at each visit. People were supported to make their own decisions and choices. One person was subject to an order of the Court of Protection and another had a Lasting Power of Attorney in place. Some people chose to be supported by family members when making decisions. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The provider understood this process.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service worked jointly with health care professionals, such as occupational therapists.

People felt staff were very caring. People said they were relaxed in staffs company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and knew people and their support needs very well.

People told us they received person centred care that was individual to them. They felt staff understood their specific needs relat

Inspection carried out on 28 and 29 April 2015

During a routine inspection

The inspection took place on 28 and 29 April 2015, and was an announced inspection. The provider was given 48 hours’ notice of the inspection. The previous inspection on 4 November 2013 was a follow up inspection, to look at previous breaches in the areas of care and welfare of people who use services, management of medicines, requirements relating to workers and assessing and monitoring the quality of service provision. The provider had taken action and there were no breaches in the legal requirements.

One 2 One Private Care Services provides care and support to adults in their own homes. It provides a service mainly to older people and some younger adults and people who have a learning disability. At the time of the inspection it provided a personal care service to 7 people. It provided short visits to people as well as visits up to six and a half hours. It would provide 24 hour care to support people if required.

The service does not require a registered manager as the provider manages the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 managed their own medicines. Staff were applying creams as part of personal care routines, but there were no proper records maintained.

People were involved in their initial assessment and the planning of their care and support and some had chosen to involve their relatives as well. Care plans did not always included people’s preferred routines, their wishes and preferences and skills and abilities. People said the provider visited periodically to discuss the care plan review, but there were not always records of these discussions. Risks were assessed and practices were in place to keep people safe, but the details of how people were to be kept safe were not always fully recorded in risk assessments.

New staff underwent an induction programme, but not all of this induction was evident in records. Induction included relevant training courses and shadowing the provider, until staff were competent to work on their own. Not all staff had received training appropriate to their role and some refresher training had been delayed. Not all staff had received spot checks on their practice, or appraisals to enable them to carry out their duties effectively.

People felt safe whilst staff were in their homes and whilst using the service. The service had safeguarding procedures in place, although most staff had not received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns.

People had their needs met by sufficient numbers of staff. People received a service from a very small team of care workers. People’s visits were allocated permanently to staff rotas and these were only changed when staff were on leave. Staffing numbers were kept under constant review.

People were protected by robust recruitment procedures. Staff files contained the required information.

People were happy with the service they received. They felt staff had the right skills and experience to meet their needs. People said their independence was encouraged wherever possible.

People told us their consent was gained at each visit. People were supported to make their own decisions and choices. One person was subject to an order of the Court of Protection and other people had Lasting Power of Attorney in place. Sometimes people chose to be supported by family members to make decisions. The provider understood their responsibility under the Mental Capacity Act (MC) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant.

People were supported to maintain good health. People told us staff were quick in spotting any concerns with their health and reported these appropriately.

People felt staff were caring. People were relaxed in staff’s company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. People said staff were kind in their approach and knew them and their support needs well.

People told us they received person centred care that was individual to them. They felt staff understood their specific needs relating to their age and physical disabilities. Staff had built up relationships with people and were familiar with their personal histories and preferences.

People told us that communication with the office was good or excellent and if there were any queries they called the provider and they always responded immediately.

People felt confident in complaining, but did not have any concerns. People had opportunities to provide feedback about the service provided both informally and formally. Feedback received had all been positive.

People felt the service was well-led. The provider adopted an open door policy and took swift action to address any concerns or issues straightaway to help ensure the service ran smoothly.

The provider had a philosophy and principles. Staff were not directly aware of these, but felt the service listened, was very caring and promoted dignity and respect. Staff said they treated people how they would want to be treated.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.

Inspection carried out on 4 November 2013

During an inspection to make sure that the improvements required had been made

On 28 June 2013 we inspected One 2 One Private Care Services and found non-compliance in the areas relating to care and welfare, management of medicines, requirements relating to workers and assessing and monitoring the quality of service provided. This was a follow up inspection to check compliance against those areas.

During this inspection we visited the office and spoke with the provider and a member of staff. We later spoke to two people who used the service, three relatives and four staff by telephone.

People spoken with told us they were satisfied with the service received and that their care was personalised to their needs. Comments included, �They are a damn site better than any other agency in this area�. �I give them eight or nine out of 10�. One relative told us, "They are excellent, Mum loves them coming�.

People said they got their medication when they should.

People felt that the service recruited the right calibre of staff.

People spoken with told us they had been asked for their feedback on the service they received. There were systems in place to assess and monitor the quality of service people received.

Inspection carried out on 28 June 2013

During a routine inspection

We visited the office and spoke with the registered manager and two members of staff. We later spoke to four people who used the service, three relatives and four staff by telephone.

People spoken with told us they were satisfied with the service received and that their care was personalised to their needs. Care was delivered by a small team of care workers to ensure people had continuity. One person said, �They are very friendly, reliable and I have no problems�. Another person said, �I really like the way they do my care, they are friendly�. Most people were aware of their care plan folder, although not their care plan. We found that care plans lacked detail about people�s needs, wishes and preferences. People confirmed that they had given their consent and been involved in discussions about their care, sometimes with a family member, when the service had first started. People said they got their medication when they should, although we found shortfalls in the systems to manage people�s medication safely.

People felt that the service recruited the right calibre of staff. However we found shortfalls in recruitment procedures. One person said, �When one (staff) leaves, the new one shadows one of the other experienced ones before they take over�. People spoken with told us they had been asked for their feedback on the service they received.

Inspection carried out on 23 May 2012

During a routine inspection

We made an unannounced visit to the agency office and we telephoned some people who use the service to gain their views and opinions. Six of the seven people we spoke to, spoke highly of the service they received. People said that they were happy and satisfied with the service.

The majority of people told us that their carers arrived on time and stayed the allocated time. One person said that if the carer was going to be late, the office always let them know in advance. They said that they had regular carers so they got to know and trust them.

People told us that the staff were respectful and kind. One person said �They are brilliant, they have never been late� and �I have the same carer, I like the consistency�.

Another person said �I am very happy with the service�.

People told us that they felt safe when carers were in their homes.

A health care professional told us that the agency was very good at communicating with them. They said �They give really good continuity of care. I recommend them all the time, absolutely marvellous care�.

A relative said �I chose the agency with great care. They do all I want and are obliging with extra visits. I phone in the morning and they come out straight away. They give an excellent service.�