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Community Caring Limited Requires improvement

We are carrying out a review of quality at Community Caring Limited. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 18 July 2019

During a routine inspection

About the service: Community Caring is a domiciliary care agency providing personal care and other types of support to people living in their own homes. At the time of the inspection 425 people were supported by the service. Of the 425 people supported by the service, 245 received help with personal care. The Care Quality Commission only regulates personal care.

People’s experience of using this service:

The way the service managed and monitored the administration of medication was unsafe. Information on the medication people needed and the guidance given to staff with regards to their administration was inadequate. As a result, some people did not receive the correct amount of medication they needed to keep them safe and well. There were no adequate systems in place to monitor the safety of medication administration in order to protect people from avoidable harm.

Risks to people were not properly assessed and planned for and staff did not have sufficient guidance on how to care for people safely. People’s assessments and care plans regarding their care and support needs lacked important information and were not always accurate or kept up to date. This placed people at risk of receiving inappropriate and unsafe care.

The support people received was not always in accordance with what had been planned or agreed. For instance, the timing and duration of some people’s visits did not always correspond with their care plans or their agreed timetable of visits. This meant there was a risk that people did not always receive the level of support they needed. Where people needed nutritional support, their dietary records did not always show that they received adequate support to maintain their nutritional well-being.

Where people had communication needs or struggled to understand the care choices available to them staff had little guidance on how to communicate with them effectively. Information about the service was also not always available in a format people could easily understand.

Where people lived with medical conditions that may have impacted on their ability to understand and consent, it was difficult to see if any consideration had been given to the Mental Capacity Act when planning or reviewing their care. We have recommended that the provider reviews the implementation of the Mental Capacity Act to ensure the service compiles in full with this legislation.

The systems and governance arrangements in place to monitor the quality and safety of the service were ineffective. They failed to identify the areas for improvement we found at this inspection and failed to mitigate risks to people’s health, safety and welfare. We also found that although the management team were clear about their roles and responsibilities they lacked sufficient insight into the delivery of people’s care and the issues we identified at this inspection. This meant that the service was not well led.

People’s feedback on the service was positive. They told us that staff were kind, caring and patient and knew them well. Most people said they received support from the same staff team most of the time. This was good practice and enabled people to get to know and build positive relationships with the staff supporting them.

People told us their privacy and dignity were always respected and their independence promoted as much as possible. They told us they knew how to make a complaint but no--one we spoke had any complaints and were happy with the service they received.

Staff were recruited safely and received regular supervision and training. People told us they felt the staff were well trained and had the skills and knowledge to provide the support they needed. Spot checks on the competency of staff however were not always undertaken in accordance with the provider’s policy.

Throughout the inspection, the management team were open and transparent. It was obvious they were passionate about the service and committed to ma

Inspection carried out on 25 October 2016

During a routine inspection

Community Caring provides personal care for people aged 18 years or over who need care or support at home. At the time of this inspection, 288 people were in receipt of support from the service. The majority of people who used the service had their care funded by their local authority. People could also pay for their own care. The service operates mainly in Wirral.

There was a registered manager in post who participated in the inspection visit. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run’.

We looked at the care files belonging to eight people who used the service. We found they covered people’s needs and risks and provided adequate guidance to staff in the provision of safe and appropriate care. Care plans were personalised to people’s individual needs and it was evident that people had participated in their development. People we spoke with confirmed this.

None of the people whose care files we looked at had mental health issues that impacted on their ability to consent to decisions about their care. Where people had mental health issues that made them forgetful, there was information in the person’s care file about their level of understanding and concentration so staff could be aware of this during a visit. The provider had a policy in place for advising staff what to do should they suspect a person’s capacity for a specific decision may be in question. The manager told us that where concerns about a person’s capacity to make a particular decision had been raised previously they had liaised with the Local Authority to support the person with this.

We saw from people’s daily logs that people received the care they needed. Records showed that most of the time people received support from a small team of regular staff. This enabled people and staff to get to know each other and build positive relationships. The majority of people we spoke with were more than happy with the staff that supported them. They felt safe and well looked after. Relatives we spoke with confirmed this. Everyone we spoke with said that staff treated them with dignity and respect and everyone felt their regular staff were well trained, understood their needs and knew what to do.

We saw that telephone calls were made to people every six months by a care co-ordinator. These calls were to check on people’s welfare, to ensure people were receiving the support they needed and that they were happy with the service provided. Annual reviews of people’s also care took place and where changes were required, we could see that care plans had been updated and the delivery of care adapted to ensure the service continued to meet people’s needs.

From people’s daily logs and other information we were provided with during our visit, we saw evidence to indicate that visits were well planned. It was clear that the majority of staff had sufficient time to complete the tasks they were required to do during a visit within the allocated amount of time. Late and missed visits were monitored via a ‘live’ system that electronically monitored the start and end time of each visit to ensure visits were conducted as planned. The manager and care co-ordinators received an email alert if a visit had not started at the planned time. This enabled a welfare call to be made to the person with another member of staff sent to complete the visit if necessary. An ‘out of hours’ call system was also in place to enable people to contact a care co-ordinator ‘out of office’ hours if they needed to do so. This ensured continuity of care and kept people safe.

Staff were recruited safely with all appropriate pre-employment checks undertaken. Staff training records showed t

Inspection carried out on 27 January 2014

During a routine inspection

At the time of this inspection Community Caring Limited were changing from a traditional domiciliary care agency to one that would provide rehabilitation to people within their own homes. This service would usually last up to six weeks and should people require support after that time then another provider would be sought. During the phone calls to people who used the service there was some concern and fears about the change that would be taking place due to the fact that the care they received was so good and that they didn�t want to change carers or provider.

We looked at five support plans and other care records for people who used the agency and they all had an assessment of their health and social needs completed. The documentation was up to date and reviewed on a regular basis. People confirmed they were involved in the development of their support plans and that these were reviewed with them.

We looked at the management of medication and saw that the service had appropriate policies and procedures in place. Staff received training in medication and people who used the agency confirmed that staff supported them with administration of medication when necessary.

We were supported by an expert by experience who spoke on the phone with sixteen people who used the agency and their relatives. This is a person who has personal experience of using or caring for someone who uses this type of care service. We also spoke with five staff members during the inspection. People we spoke with confirmed they were satisfied with the service.

People who used the service said: �They are very good indeed, and I am very pleased with them�, �The care my mother has is very good�, �The care is good, although I do have different carers and would like to have familiar faces� and �The carers know my wife�s whims, and threat her with dignity and respect.� All the people who used the agency and their relatives agreed that on the whole the carers turn up on time and stay for the allocated length of time.

Staff commented: �Where possible we have the maximum team of three carers for each call�, �The training here is excellent�, �I think the care plans are detailed and person centred�, �I like getting to know the people I support and seeing them get stronger� and �We have regular meetings.� All the staff said they got good support from the management team and that they had no concerns about the welfare of the people they supported.

We looked at staff recruitment and saw that appropriate processes were in place and that people who used Community Caring Limited were protected by robust recruitment processes and practice.

We looked at the complaint process and procedure. We saw that where complaints had been made to the agency appropriate records had been kept and we saw these during the inspection. People we spoke with stated they didn�t have any complaints.

Inspection carried out on 18 September 2012

During a routine inspection

We spoke to four people who used the service and three relatives who told us that they were happy with the service provided. They said that the staff were polite, caring and helpful. They had been involved in drawing up their care plans which indicated the support they required.

The manager had sent surveys to the people who used the service to find out their views about how the service was operating. Forty-nine responses were returned. We looked at twenty five of these and found that the majority of people were happy with the care and support they received. Twenty four people rated the service as excellent or good. One person said the service was satisfactory.

The people we spoke to said that they knew how to make their views known if they were not happy with the service. Records showed that any issues raised about the service where looked into and action taken to address any shortfalls.

The service promoted the involvement of the people who used the service in their care. Records showed the care and support people needed and how any risks to their welfare were to be managed.

Staff had received the training they needed to appropriately support the people who used the service.

We found there were effective systems in place to monitor the quality of the service and to ensure people received safe and effective support.