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Inspection carried out on 23 July 2019

During a routine inspection

About the service

Sentinel Care Limited is a domiciliary care service providing support to 104 older people in their own homes, some of whom have being diagnosed with dementia care needs. 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 inspection, 80 people were receiving a regulated service.

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

People received safe and effective care and support. Risks were assessed and managed to reduce the likelihood of avoidable harm and changes in circumstances were immediate addressed to ensure people remained safe. People received timely support from a consistent staff team. Systems used for the management of medicines were safe and people received their medicines as prescribed.

People’s needs were assessed and reviewed to ensure their care needs were met. Care plans were updated promptly so staff always had access to the most current information.

Staff received training relevant to their role and had good support from the provider, registered manager and colleagues.

Staff sought people’s consent before providing care and decisions about people’s care and treatment were made in line with law and guidance. People received enough to eat and drink to maintain their health. People were supported to access healthcare agencies when required. The provider worked in partnership with health and social care professionals to ensure consistency and ensure people received appropriate support.

People’s care was responsive to their changing needs. People, and their relatives, were involving in the assessment and planning of their care and communication was good to enable people to work together to ensure people’s needs were met fully. People knew how to raise a concern and always felt listened to.

People, relatives and staff felt the service was well managed. People, and staff, had regular opportunities to share their views about the service. The provider carried out audits to ensure the quality of care provided.

People were supported to make choices and retain control of their lives and staff supported them in the least restrictive way possible and in their best interests. Policies and systems in the service supported this practice.

Why we inspected: This was a scheduled inspection based on the previous rating.

Rating at last inspection The last rating for this service was good (published September 2016).

The service met the characteristics of ‘Good’ in all areas; more information is available in the full report below.

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

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.

Inspection carried out on 7 September 2016

During a routine inspection

Our inspection took place on 7 and 8 September and the 6 October 2016. We announced the inspection as the provider is a domiciliary care agency and we needed to be sure someone would be available. This was the locations first inspection under the new methodology. We last inspected this service on 30 January 2014 and found the provider was meeting the standards required.

Sentinel Care Services provides personal care to people living in their own homes. At the time of our inspection the service was supporting seventy seven people.

People were supported by staff who could recognise potential signs of abuse and were confident reporting concerns regarding people’s safety. People were supported by sufficient numbers of staff who had been recruited safely. Risks to the health, safety and well-being of people were identified, managed and regularly reviewed. Staff had a good understanding of how care and support should be provided in order to keep people safe and were able to tell us about people’s individual risks and how to manage them. Accidents and incidents were recorded and investigated and we saw the provider was using this information to ensure risks of re-occurrence were reduced. People received their medicines on time and as prescribed.

People and their relatives told us they mostly received their support calls on time and by consistent staff. Most people and their relatives told us they were informed if for any reason their call was going to be late, however a few people and relatives told us that this was not always the case. The provider had a system to monitor calls and action was taken where calls were late or missed.

People were supported by staff who had sufficient training to meet their needs. People consented to their care and support and people were supported by staff who understood the principles and application of the Mental Capacity Act. However, people’s care records were not written in a way that reflected the decisions that should be made in people’s best interests where they lacked capacity to do so themselves.

People received support with food and drink when required and their dietary and nutritional needs were identified and appropriately managed by the staff team. People had access to healthcare professionals when required and were supported to maintain their health.

People were supported by staff who were caring and treated people with kindness and respect. People and their relatives told us staff developed positive relationships with them. People were involved in making decisions about how their care and support was provided. Staff supported people in a way that maintained their privacy and dignity and promoted their independence.

People and their relatives were involved in the assessment, planning and review of their care and support needs. People were supported by staff who had a good knowledge and understanding of their needs and preferences and were providing care and support in a way that respected them. . People and their relatives knew how to raise a concern or complaint and most people we spoke with told us that concerns and complaints were acted on.

People and their relatives felt the service was well managed and the quality of the care was good. People, relatives and staff told us that the registered manager and the directors were approachable and supportive. Staff felt supported in their roles and understood their responsibilities. There was an open and honest culture within the service and people, relatives and staff were provided with opportunities to provide feedback. The registered manager had systems in place to monitor the quality and consistency of care and the information from these checks was being used to drive improvement.

Inspection carried out on 30 January 2014

During a routine inspection

During this inspection we spoke in private with people who used the service and staff. We also spoke with the managing director, registered manager and operations manager.

People told us that they were very happy with the care staff who supported them. One relative told us, �They monitor my Mum and do a good job�. Other comments included, �I�m 98 now, they�ve grown with me. They�ve accommodated my individual needs as I�ve got more dependant, they are very good carers� and �These girls are lovely they work hard�.

People told us the care staff were flexible and tried to fit in with their wishes. One person told us, �I like to approve my carers, I�ve had a couple of rejections but we�ve dealt with that�. People told us that generally they received care from regular staff who knew their needs well. People told us they had been consulted about their care plans and involved in regular reviews of their care.

We found that care was planned and delivered in line with people's assessed needs and care plans were updated on a regular basis. The provider trained staff in safeguarding vulnerable adults and people told us they felt safe with the care staff. We saw that staff were supervised and their competency was monitored on a regular basis. Staff told us they felt supported in their work.

We found that the provider had systems in place to monitor the quality of the service. This ensured that the service was effective and well led.

Inspection carried out on 4 September 2012

During a routine inspection

We spoke with five people who used the service, five care workers and two members of the management team. People shared very positive experiences of the care and support they received. Comments included, �The staff are really wonderful to us, we couldn�t wish for anything better.� �I�ve never regretted choosing Carewatch, the staff do their job perfectly, I�m very happy indeed.�

People told us they received information about the agency before they agreed to the service. They said their care needs were assessed and they were involved in planning and reviewing their care. People told us staff respected them and maintained their privacy and dignity.

People said they felt comfortable and safe in the presence of the staff. One person commented, �The staff are very trustworthy.� Another person said, �I feel safe with the staff and trust them all.� Staff told us they had received training in safeguarding people and knew the procedure to follow to report any concerns that may arise.

People said they liked the staff. Staff told us the agency had undertaken checks on them to ensure they were safe to work with vulnerable people. We saw the agency had effective recruitment and selection processes in place.

People told us they were �very� satisfied with the service. They said the agency regularly gained their views about quality through satisfaction surveys or spot check visits to their home.