Northern Home Care Ltd

Northern Home Care is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection five people were receiving care.

People’s experience of using this service and what we found

People were well protected from the risk of abuse or neglect and told us the service helped them to feel safe. Staff had completed training in adult safeguarding and understood their responsibilities to report concerns. Appropriate checks were completed before new staff started work. Staff reported incidents and accidents in sufficient detail to aid analysis and reduce risk.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to maintain a healthy diet in accordance with their needs and preferences. Northern Home Care worked with other agencies to provide care which had a positive impact on people’s health and wellbeing. When people were unwell staff acted promptly to ensure that they received appropriate care and treatment. People were involved in discussions about their care and their outcomes were good. Staff were given training in accordance with recognised standards for care staff. Staff told us that they felt well supported.

People and their relatives spoke very positively about the caring nature of staff. They told us that they were always treated well by staff and were consulted about their care. Staff were clear about their responsibilities in relation to equality and diversity and supported people appropriately. People were encouraged to comment on the provision of care and were actively involved in the decision-making process through discussions with staff and regular meetings. Important decisions were recorded in care records and reviewed. Staff explained how they supported people with their personal care needs in a discrete and sensitive manner.

We saw evidence that people’s individual needs and preferences were considered as part of the care planning process. We also saw that needs and preferences were reflected in the way care was provided. Staff understood the need for effective communication and met the requirements of the Accessible Information Standard (AIS). People understood the complaints procedure and were provided with a written copy. The service had not received any recent complaints. The service did not routinely support people receiving end of life care.

Each of the staff we spoke with understood their role and responsibilities. Throughout the inspection the comments and behaviours of the registered manager and staff consistently reflected their commitment to a person-centred service. It was clear that this had resulted in positive outcomes for people. Staff told us that they would not hesitate to inform senior staff of a concern or error. We saw evidence errors and performance issues had been recorded, reported and addressed appropriately. The service made effective use of audits, reports and other forms of communication to monitor and improve the safety and quality of care. Partnerships had been developed with other services in the area to improve outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 17 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Northern Home Care Limited is a small domiciliary care agency providing personal care to older people in their own homes. At the time of our inspection the agency was delivering 51 hours of care to seven people. There were two staff (including the registered manager) employed to undertake these hours, plus one bank staff.

There was a registered manager in post. 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.

During the previous inspection in November 2015 we identified a breach of regulation because care records were poorly organised making it difficult to access important information. At this inspection we checked records and other documentation to ensure that improvements had been made and sustained.

We found that the provider had made the necessary improvements regarding records and that this breach was now met.

At the last inspection in November 2015 we found that people’s care records did not contain sufficient person-centred information for staff to know them. This did not have any obvious impact on the care provided because staff had worked with the same people for a long time and knew them well. However, new staff would require more detailed information to be able to provide high-quality, effective care. We made a recommendation regarding this.

During this inspection we looked at care records and person-centred plans to see if the necessary improvements had been made and sustained. We saw that care records contained plans which were clearly person-centred and focused on people’s independence.

At the last inspection we found that risk assessments were not sufficiently detailed to support staff in providing safe care. We made a recommendation regarding this. During this inspection we checked what progress had been made. The provider had developed risk assessment processes to include a risk screening document. This allowed them to effectively assess a range of risk factors and establish if they required further consideration.

People we spoke with told us they felt safe. The comments that we received from people using the service and a relative regarding safety were very positive.

Northern Homecare had access to sufficient staff hours to cover its responsibilities and was actively recruiting in anticipation of growth. Recruitment procedures adhered to safe-practice guidelines.

The provider had a training plan in place and made use of e-learning to facilitate a range of course which were appropriate to meet the needs of people using the service. These included; Health and safety, equality and diversity, adult safeguarding, dementia awareness and the Mental Capacity Act 2005 (MCA).

We asked about arrangements for staff supervision and appraisal. We were told that because the service was small, there was daily contact and support available. We saw from records that more formal supervision was completed quarterly.

At the previous inspection we noted that information relating to Lasting Powers of Attorney (LPA) was not recorded in people’s care records. We spoke with the registered manager about this who confirmed that none of the people currently receiving a service had an LPA decision in place. They also confirmed that details would be recorded if the situation changed.

We asked people about the support they received to eat and drink. Each of the people that we spoke with said that they had no issues with how staff supported them or the quality of food that was prepared.

People spoke positively about the support they received with their healthcare. We saw notes relating to medical histories and healthcare appointments in care records.

Each of the people that we spoke with was extremely positive about the staff and the quality of care that they received. People told us how they were involved in decisions about their care and how flexible the care staff were. The staff member that we spoke with and the registered manager clearly knew each person and their needs well. They had positive, professional relationships with people and their families.

We asked people if they knew what do if they needed to make a complaint. Each of the people we spoke with told us they had never had to make a complaint, but understood who they should speak to if required.

The provider issued annual questionnaires which gave people the opportunity to comment on performance and suggest improvements. The most recent questionnaires were issued in June and July 2016. Thirty six percent of the questionnaires were returned. In each case the responses were exclusively positive. None of the respondents or the people that we spoke with suggested any areas where the service could improve.

The registered manager was aware of their responsibilities regarding their registration with the Care Quality Commission and demonstrated responsibility and accountability in discussions about the improvements made following the last inspection.

The service operated quality and safety systems that were suited to a small operation and alerted the registered manager to issues and concerns in a timely manner.

The service utilised a basic set of policies and procedures including those for; confidentiality, safeguarding and whistle-blowing. The policies contained sufficient information to inform staff, but had not been subject to a recent, formal review. We spoke with the registered manager about this who confirmed that all policies would be reviewed to ensure that the information and guidance was current and fit for purpose.

At this visit we viewed the policies and procedures held by the service and talked with three members of staff. We saw evidence which demonstrated that people who used the service were protected from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse occurring by ensuring that staff had received appropriate training and that policies and procedures were up to date and available to staff.

Positive comments shared by them included:

'Brilliant, they are really good'; 'We are very happy with them'; 'We have all the contact numbers including the managers already programmed in our phone'; 'It's good we see the same staff' and ' We see the manager and staff and they always asks us about the care provided.'

We lreviewed a sample of policy documents for procedures and guidance to help inform each staff member's practice. The manager advised she would review all policies to ensure they were updated with all necessary information to help manage the service.

Following our visit the manager has confirmed she now has the local authorities 'safeguarding policy' in place and is updating the services own policy. The manager has also told us she has made arrangements to ensure that all staff are provided with suitable training in 'safeguarding vulnerable adults.'

'They are marvellous, very caring and they never let you down. I don't think we could've done any better'.

'They are very caring and are more like friends. They have made all the difference to us, we couldn't manage without them'.