Agincare UK Dorchester

Agincare UK Dorchester is a domiciliary care service that provides support and personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection 67 people were receiving support with personal care.

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

People told us they felt the care they received made them feel safe and they were confident they were well looked after. Staff understood their roles and responsibilities in keeping people safe from harm.

Risks to people had been assessed and once identified these risks were usually managed safely by competent staff. There were robust systems in place to ensure people’s medicines were managed safely in ways that suited their lives. Staff supported people to access any equipment they needed to ensure their homes remained safe.

Sufficient numbers of suitably qualified and skilled staff were deployed to meet people’s individual needs. Staff received training and support to enable them to carry out their role safely and effectively. People told us they received the right care and support from staff who were well trained and knew them well. People also told us staff usually arrived on time.

People received personalised care as described in their care plans. People told us they received the help they needed and that staff were kind and caring and always treated then with respect.

Care plans identified the outcomes that mattered to people and how they were to be met. People received the support they needed to maintain good food and drink intake and access to healthcare was supported.

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 and family members knew how to make a complaint and were confident their complaint would be listened to and acted upon.

People and family members spoke positively about the management of the service and described the registered manager and staff as approachable. Staff felt supported in their role and were committed to delivering the person-centred care and approach encouraged by the registered manager and provider. Effective quality assurance systems were in place to monitor key aspects of the service.

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 (report published 6 January 2017)

Why we inspected

This was a planned inspection scheduled in line with 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.

This inspection was announced and took place on 7 December 2016. The provider was given 48 hours’ notice of inspection to ensure the registered manager would be available to meet us at the provider’s office and also to make arrangements for us to visit some of the people in their own homes.

The last inspection of the service was carried out on 30 January 2014. No concerns were identified with the care being provided to people at that inspection.

Agincare UK (Dorchester) is a domiciliary care provider offering care and support to people living their own homes in Dorchester and surrounding areas. In addition they also provided care and support at an extra care scheme. This includes providing 24 hour on site care and support. They are registered to provide personal care. At the time of this inspection they were providing personal care and support for 92 people in their own homes.

There is 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.

People and their relatives were very complimentary about the quality of the service provided and about the management and staff team. They felt the care was exceptionally good. One person said, “The carers are happy, pleasant, chat and laugh with me”.

People we spoke with felt they received support from familiar and consistent care workers. They told us they would recommend the service to other people. They confirmed care workers arrived on time and had the skills and knowledge to provide the support they needed. One person told us, “The carers know their jobs and do what I want.” A relative told us, “I see them [carers] every day, and they know what they are doing and have the correct skills to support my relative”.

The provider had effective systems to manage staff rosters, match staff skills with people’s needs and identify what capacity they had to take on new care packages. This meant that the service only took on new work if they knew there were the right staff available to meet people’s needs.

The office care coordinators planned visits to make sure staff arrived to each person at the agreed time.

The provider had a recruitment procedure that ensured the suitability of staff was checked before they began work. Staff knew how to recognise signs of abuse and all said they were confident that any issues raised would be appropriately addressed by the registered manager. People felt safe with the staff who supported them. One person told us, “When they are leaving they always make sure the key is put back in the correct place. That makes me feel safe when I’m alone.

Staff completed an induction when they first started working at the agency. They also shadowed more experienced staff and worked through an induction booklet. This covered information about the provider, human resource topics, and all aspects of caring for people and managing risks, and essential health and safety subjects such as fire, infection control and manual handling.

People had positive relationships with the care workers who supported them. Staff knew people’s individual histories, likes and dislikes and things that were important to them. People’s privacy and dignity was respected and information personal to them was treated in confidence.

Care was planned and delivered in a way that was personalised to each person. Staff monitored people’s healthcare needs and, where changes in needs were identified, care was adjusted to make sure people continued to receive care which met their needs and supported their independence. Care plans gave clear information about the support people required to meet both their physical and emotional needs and had information about what was important to the person.

Risk assessments included risks associated with people’s homes and risks to the person using the service. Staff had access to care plans and risk assessments and were aware of how to protect people from risks of harm.

People received help with their medicines from staff who were trained to safely support them and who made sure they had their medicine when they needed it. The provider undertook regular competency checks on staff to ensure they followed safe practice when supporting people.

The provider had a clear vision, which was to provide a service which was influenced by the needs and wishes of the people who used it. There was a commitment to providing high quality care which was tailored to people’s individual wishes. Their vision and values were communicated to staff through staff meetings, supervisions and a regular newsletter. People’s views were gathered by regular monitoring visits and phone calls and by satisfaction surveys

There were systems in place to monitor the quality of the service and plan on-going improvements. People using the service and staff felt involved and able to make suggestions or raise concerns.

Care plans that we looked at evidenced staff supporting people to make their own choices about what they had for lunch, what activities they took part in and what they needed support with. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

Records that we looked at evidenced that people were involved in choosing how and when they wanted their care and support. This indicated that people were involved in planning their care on a daily basis.

A social worker we spoke with told us "the care staff and office staff are very professional. They have made my job much easier and are a pleasure to work with. We maintain regular communication and they keep me updated about the people they support - I never have to chase them".

A family member told us "they provide a very high standard of care and we could not ask for more. I can relax knowing that my mum and dad are in safe hands and that their every need is being met" and another said "my mum thoroughly enjoys her visits and likes spending time with the girls. She is always telling me how lovely they are and how much she appreciates their support and kindness".

The registered manager told us that consent for care and support was obtained from people using the service or their representatives during discussions about the care and support people needed. One care worker told us; 'I know that people have agreed to care because it's in their notes but I still always ask them every time if its ok for me to give them care'

Copies of care plans were held at the agency office and at the home of the person receiving care. We looked at a sample of care plans. These gave clear guidance about the care and support that was to be provided to the person. People told us that they could raise any concerns and the agency would respond to them appropriately.

Appropriate checks were undertaken before staff began work. We looked at five staff files and saw that the necessary checks had been made before people started to provide care in people's homes. We saw that Disclosue and Barring checks, formally Criminal Records Bureau checks (CRB) had been completed.

We spoke with five people who use the service. They said that they had not had to make a complaint but knew how to do so if they needed to. Details on how to make a complaint were in the Care Services Guide that was given to people before their care commenced.