YS Services Limited trading as Embracing Care

People’s experience of using this service: People told us they received a good service and felt safe with the support they received from staff. Arrangements were in place to protect people from risks to their safety and welfare, including the risk of avoidable harm and abuse. Effective recruitment procedures were in place and people received care in a timely way. Arrangements were in place to protect people from the risks associated with the management of medicines and the spread of infection.

People’s care and support was based on detailed assessments and care plans which were regularly reviewed and updated. Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported to eat and drink enough to maintain their health and welfare. People were supported to access healthcare services.

Staff had developed caring relationships with people they supported. People were supported to take part in decisions about their care and treatment and their views were listened to. Staff respected people’s independence, privacy and dignity.

People’s care and support considered their abilities, needs and preferences and reflected their physical, emotional and social needs. People were kept aware of the provider’s complaints procedures.

Effective management systems were in place to monitor the quality of the care provided and to promote people’s safety and welfare.

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

Rating at last inspection: The rating at the last inspection was Good. The report was published on 5 August 2016.

Why we inspected: This was a planned inspection. It was scheduled based on the rating at the last inspection.

Follow up: We will continue to monitor the service to make sure people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in line with our inspection programme.

YS Services Limited trading as Embracing Care is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout areas of County Durham and provides a range of home care and support.

At the time of our visit there were approximately 492 people using this service who were supported by 148 staff.

There was a registered manager in place who had been in their present post at the service for over five years. Prior to this the registered manager had also worked in care and senior positions in the organisation. A registered manager is a person who has registered with the Care Quality Commission (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.

Everyone who was using the service had a care plan which described how their individual care and support needs were to be met. This meant that everyone was clear about how people were to be supported. These were evaluated, reviewed and updated as required. People who used the service and those who were important to them were actively involved in deciding how they wanted their care, treatment and support to be delivered. The registered provider had detailed plans in place to ensure care plans were accurate, easy to use and kept up to date.

The registered provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. These included risks to service users and staff due to infections. We saw risk assessments were carried out, including reduction measures and these were updated if new situations or needs arose.

The registered provider operated recruitment procedures which were robust to protect people using the service from unsuitable staff. The provider undertook thorough background checks for staff before they started working with vulnerable people.

Feedback from people using the service showed that staff and the registered manager were friendly, open, caring and diligent; people using the service trusted them and valued the support they provided. People told us they were happy with the support from this agency and felt they were in control of the support they received.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We found the registered manager had a good understanding about how the service was required to uphold the principles of the MCA, people’s capacity and ensure decisions about their best interests were robust and their legal rights protected.

The registered manager and staff that we spoke with promoted peoples’ health and wellbeing and it was evident that staff knew people who used the service well. This included their personal preferences, likes and dislikes. Staff had used this knowledge to form caring and therapeutic relationships. These relationships improved the agency’s effectiveness and helped them make changes in response to people’s needs or in response to emergency situations.

People were supported by staff who had received appropriate training. The registered provider made sure that staff were provided with training that matched the needs of the people they were supporting. This was particularly important where staff were supporting people with complex conditions which required staff to have and maintain specific skills. Where staff undertook specialised training, their work was overseen and monitored by suitably qualified staff from other organisations.

People were protected from the risk of abuse. Staff and the registered manager understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. When asked they were able to describe what actions they would take if they witnessed or suspected abuse was taking place and what they expected of service colleagues and statutory agencies. Staff were aware of their role in protecting people from harm and were diligent in checking for signs of abuse.

We saw the registered provider had detailed policies and procedures for dealing with medicines so that they could be followed by all staff. Staff were undertaking intensive refresher training about how medication was to be administered which included likely mistakes and how they could be avoided. When required each person had a medicine administration care plan that was personalised and dependant on people’s needs and varying condition. Safeguards were in place where people required support with treatments. Medicines were securely stored and there were checks in place to make sure people received the correct treatment.

The registered provider had a complaints policy which gave people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. Staff we spoke with understood how important it was to act upon people’s concerns and complaints and would report any issues that were raised, to the registered manager. People who used the service and those who were important to them knew about the complaints process and told us they had confidence that these would be handled appropriately by the registered provider.

We found that the registered manager and registered provider had systems in place to monitor the quality and ensure that the aims and objectives of the service were met. This included audits of key aspects of the service, such as medication and learning and development, which were used to critically review the service. We also saw the views of the people who used the service and those who were important to them, were sought. The registered manager produced action plans, which showed when developments were planned or had taken place. The services operations were also subject to oversight and performance management by the registered provider.

We saw the provider had employed a member of staff for the purpose of writing care plans. All people who used the service were to have their care plans reviewed and re-written. We saw the provider had nearly completed this process and new care plans had been written for approximately 70% of people who used the service at our last inspection and for all people who had started using the service since the date of our last visit.

We spoke with some people about the care they received. One person told us 'They (the care staff) are very good' another told us 'One of them is very good. My (relative) is treated well.' We were also told 'I can't fault them (the care staff).'

In addition some of the other people who used the service told us 'Some of the carers are more patient than others' and another person told us 'My (relative) always appeared anxious when one of the carers came around.'

We saw the provider had ensured all staff working for the agency had undergone training in infection prevention and control. The provider told us all staff were required to wear personal protective equipment (PPE) and staff were provided with disposable gloves and aprons which they carried with them when going to visit people who used the service.

We saw the provider carried out an annual survey of the service with service users and their families. This helped to show what they thought was good about the service and where changes could be made. The survey responses were collated and action plans were devised.