JustCo Ltd t/a Home Instead Senior Care (East Cheshire)

Justco Limited is a domiciliary care service providing 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 the inspection the service was supporting 50 people.

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

People received an exceptionally caring service. Every person we spoke with throughout the inspection praised the quality of care. People felt supported and truly valued as individuals and believed staff genuinely cared. We heard words such as ‘terrific’, ‘invaluable’, ‘genuine’ and ‘exemplary’ being used to describe the service and staff.

People's care was exceptionally responsive. Care plans were extremely person centred and care plans were developed with people. These were flexible and people could change their care plans when they chose. People were supported by small and consistent teams who knew people extremely well and trusting relationships had been formed. We saw numerous examples where the staff had gone above and beyond to ensure people’s emotional, leisure and cultural needs were met. We were consistently told that staff were sensitive and respectful when visiting people in their own homes.

There were numerous opportunities for people to access a wide range of social activities to reduce the risk of loneliness and isolation.

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.

The service was well led and staff felt well supported by an open and honest culture with a clear focus on continuous improvement.

The provider worked with other professionals and organisations to share training and ensure positive outcomes for people.

The provider was also involved in a number of initiatives to improve people’s wellbeing. These included providing advice and support to enable people to stay safe from the risk of scams and health promotion events to reduce the risks face by people of malnutrition. These initiatives were not restricted to people receiving care and were accessed by the wider community.

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 (last report published 05 January 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.

Justco Ltd is a domiciliary care agency and is branded as Home Instead Senior Care. It

provides personal care services to people in their own homes from its office located in Chelford.

Clients are served in Macclesfield as well as other parts of eastern Cheshire including Wilmslow, Alderley Edge, Prestbury and Poynton.

The service was last inspected in August 2013 when the office was located in Macclesfield. At that time the service was found to be compliant in all the areas we looked at. The service reregistered at the Chelford office in May 2014 and this was the first inspection at this site.

The service has a registered manager. 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. At the time of our inspection there were 62 people using the service.

The people who used the service and their relatives told us that they were treated with respect and kindness by the staff. Comments included, “my carer is the most caring person I could hope for” and “they are brilliant, I know they really care for me and look after me”.

Everyone we spoke with told us they felt safe when the agency staff were in their home. Risks to people’s safety and welfare had been assessed and information about how to support people to manage risks was recorded in their plan of care.

Medicines were administered safely to people by staff. We found in some cases there was a lack of clarity around the recording of people’s medicines. This was brought to the manager’s attention during the inspection and appropriate actions taken.

People told us they received care and support from a consistent staff team and the visits by staff were conducted on time.

There was a time monitoring system in place which enabled people to be confident that their visits would be carried out on time and medication would be administered at the correct time. It operated in conjunction with the office and enabled staff to telephone the office when they arrived and left a visit. Alerts were picked up by the office immediately if visits were not carried out and there was a backup duty system where senior care staff could complete the visit if necessary. People told us that all visits were carried out in full and people reported that staff were never rushed.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse. People who used the service and their relatives told us that they felt that staff provided safe and supportive care.

We looked at recruitment files for a selection of newly appointed and long term staff members to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

The registered manager ensured that staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. There was a well-established management structure in place which ensured that staff at every level received support when they needed it. Staff were clear about their roles and responsibilities and how to provide the best support for people.

People had a plan of care. The care files that we looked at contained the relevant information that staff needed to care for the person. We could see from the detailed daily records and discussions with people receiving the service that the care provided was person centred and took account of the person’s wishes and preferences.

Discussions with staff members identified that they felt happy and supported in their roles. They told us that the registered manager and provider were supportive and they felt that they could contact them at any time. Comments included, “we are well supported”, and “every month we get supervision, you cover everything, staff you support, yourself, training, everything”.

The service had a quality assurance system in place which used various checks and audit tools such as questionnaires and direct observations to monitor and review the practices within the service. Systems and processes were in place to monitor the service and drive continuous improvements. A number of audits (checks) on how the service was operating were also undertaken. These included visits approximately every three months to see people in their own home. The purpose of this was to monitor staff practice and also to check whether people were satisfied with the support they received.

The provider told us that this enabled the service to receive continual feedback and address any areas of concern immediately to ensure that the people using the service received a high standard of care.

Our findings showed that care and support was provided to people in their own home on a flexible basis and in accordance with individual need. The amount of support provided varied and people were offered a service between an hour per day to 24 hour support, seven days per week if required.

The manager had a clear knowledge and understanding of the Mental Capacity Act (MCA) 2005 and their roles and responsibilities linked to this. People told us they were able to make their own choices and were involved in decisions about their support.

The agency had a whistleblowing policy, which was available to staff. Staff told us they would feel confident using it and that the appropriate action would be taken.

A complaints procedure was in place and details of how to make a complaint had been provided to people who used the service. People we spoke with knew how to raise a complaint.