Candlelight Homecare Service Limited (East Sussex)

Updated 19 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The previous inspection of the service took place in February 2015. It was rated as good in all areas.

This inspection took place on 1 November 2017 and was announced. We gave the agency 3 days’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. Inspection site visit activity started on 27 October 2017 and ended on 7 November 2017. We visited the office location on 1 November 2017 to see the manager and office staff; and to review care records and policies and procedures.

This was a routine comprehensive inspection carried out by two adult social care inspectors and two experts by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The inspection was informed by feedback from questionnaires completed by a number of people using the service. The Care Quality Commission sent out surveys to 30 people and their relatives. We received a response from 16 people and two relatives. This confirmed overall satisfaction with the agency but negative comments were received regarding the lack of rotas supplied and people not knowing who was coming into their home. We also sought feedback from three commissioners and three health and social care professionals. No responses were received.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included previous inspection reports, safeguarding alerts and statutory notifications. A notification is information about important events which the service is required to send us by law.

We met and spoke with the acting manager, the community team manager, a community team manager assistant, care co-ordinator and one care worker. We visited and spoke with two people in their own homes. Before, during and after the inspection, we spoke by telephone to a further 15 people, three relatives and eleven care workers. Following the inspection, we discussed our findings of the inspection with the operations manager.

We reviewed information about people’s care and how the service was managed. These included: six people's care files and medicine records; three staff files which included recruitment records of the last three staff to be appointed; staff rotas; staff induction, training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incident and accident reporting; minutes of meetings and the most recent quality questionnaire returned.

Updated 19 December 2017

This comprehensive inspection took place on 1 November 2017 and was announced.

Candlelight Homecare Service Limited (East Sussex) was registered with the Care Quality Commission (CQC) in April 2014 as a domiciliary care agency. It provides personal care to a range of older and younger adults living in their own houses and flats in the community. These included people living with dementia, a mental health illness, a physical disability, a learning disability, people with substance misuse, sensory impairment or an eating disorder. The service was also registered to provide care for children from 0-18 years; although at the time of inspection no children were receiving a service.

At the time of inspection, there were 82 people receiving a service from the agency with 450 care hours carried out each week. Although the majority of people using the agency received a regulated activity, approximately 25 per cent did not; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The time of visits ranged from 15 minutes to one hour and the frequency ranged from once every two weeks to four times a day. There were 22 staff employed.

There was no registered manager in post. The acting manager was in the process of applying to the CQC to be the registered manager for the service. They had undertaken a formal interview on 27 October 2017 and were waiting the outcome. Following the inspection, we were informed their application had been successful and they were now the registered manager for the agency. A registered manager is a person who has registered with the 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 were happy with the service they received. People had built up meaningful relationships with the care workers who supported them and felt comfortable with them in their homes. Comments included, “The service is excellent … I have the best carer I have ever had … she is very good indeed … I have the same carer all the time”, “The carers do what they need to do and chat and make me laugh while they are doing it” and “They’re all really nice young girls with a ‘can do’ attitude … they whizz round in the time that they’re allowed.” However, people did not always know who was coming in to their home as they did not receive a staff rota.

People were kept safe and cared for by care workers who were aware of their safeguarding responsibilities. Staff had received training in how to safeguard people from potential abuse and knew how to identify the risks associated with abuse. Care workers were safely recruited, trained and supervised in their work. Care workers enjoyed their jobs and felt included and listened to in the running of the agency. Comments included, “I’ve been here a while and feel I’m well trained and respected” and “I feel they know I can do my job well and they ask me to attend training when it’s due.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrive way possible; the policies and systems in the service supported this practice. Care workers had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support. However, mental capacity assessments were not always carried out. We have made a recommendation about following the guidance on the Mental Capacity Act 2005.

Each person had risk assessments and a care plan in place. People were involved in the planning of their care and were regularly reviewed. One person commented, “I was consulted about everything, what time I wanted them to come and what I wanted them to do … they wrote the care plan and I was asked to look at it to be sure it was what I wanted.”

Care workers had been trained to give people their medicines safely and ensured medication administration records were kept up to date.

People were supported to eat a nutritious diet and food and drink of their choice. In between care visits, care workers always made sure people had snacks and drinks available.

People were encouraged to maintain their independence as much as possible and care workers encouraged them to maintain their health and well being.

Regular social activities and networks were planned by the agency throughout the year and people were encouraged to attend and enjoyed community links.

People and relatives were overwhelmingly positive about the staff and management of the service. They felt listened to and confident any concerns they had would be addressed and resolved.

There were some quality monitoring systems and processes in place. However, these needed to be more regularly carried out to ensure continuous development of the agency. We made a recommendation about regular quality monitoring of the service to ensure the service continually improved.