Archived: Cyprian Care Limited

Cyprian Care is a domiciliary care agency that provides personal care to people living in their own homes. At the time of our inspection the service was supporting 165 people.

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

We found that medicines were not always managed in a safe way, the service did not appropriately respond to and report on allegations of abuse to keep people safe and accidents and incidents were not analysed to prevent recurrence.

The service did not always provide staff with supervisions in line with their policy. We have made a recommendation about the supervision frequency.

Care plans did not evidence that people were involved in the planning and reviewing of their care. We have made a recommendation about documenting people are involved in making decisions about their care.

Care plans did not ask questions about all the protected characteristics relating to equality and diversity. We have made a recommendation about discussing equality and diversity with people receiving care. Staff were not equipped with the skills to provide end of life care to people and people were not given a chance to discuss their end of life wishes. We have made a recommendation about end of life care being provided where appropriate.

The governance systems in place did not identify the shortfalls we found during our inspection.

People told us they felt safe with staff. People’s risks were recorded to ensure staff knew how to keep people safe. People were protected from the risk of harm associated with the spread of infection. There were enough staff working at the service and pre-employment checks were carried out on prospective staff.

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. Assessments were undertaken to determine people's needs before they moved into the service. Staff received training to support them in their roles. Staff were provided a thorough induction and ongoing training, to enable them to provide effective care and support. People's nutritional needs were met, and the service worked well with other relevant healthcare professionals.

People told us they were treated in a caring manner by staff. Staff understood how to support people in a way that respected their dignity, privacy and promoted their independence.

People received individualised care that met their needs. The care plans were person centred and discussed people's preferences. Information was provided to people in an accessible format. People told us they felt able to make a complaint and were confident that complaints would be listened to and acted on.

People and staff spoke positively about the service and said it was managed well. There were processes in place to manage and monitor the quality of the service provided. The management team had regular contact with people using the service and their staff. The registered manager kept up to date with best practice to ensure a high-quality service was being delivered.

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 for this service was good (published 11 January 2017). The service is now rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this report.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Cyprian Care Limited provides personal care and support to people in their own homes. The service primarily (but not exclusively) works with local Turkish and Greek communities. At the time of the inspection there were 200 people using the service.

The service had 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.

People told us they were safe. Medicines were managed safely. Risk assessments identified the risks to people and how these could be minimised. There were sufficient numbers of staff available to meet people's needs.

People were involved in decisions about their care and how their needs would be met. Managers and staff had received training on the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005.

Staff had access to ongoing training. They were knowledgeable about their roles and responsibilities.

Staff knew how to respond to people's needs in a way that promoted their individual preferences and choices regarding their care. People were supported to eat and drink.

People were treated with dignity and respect. Staff understood people's preferences, likes and dislikes regarding their care and support needs.

Care was planned and delivered in ways that enhanced people's safety and welfare according to their needs and preferences.

People were supported to maintain good health and had access to healthcare services. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people's needs.

The service regularly requested feedback from people who use the service. People, relatives and staff said the management were approachable and supportive.

Systems were in place to monitor the quality of the service. People felt confident to express any concerns and these were addressed by the registered manager.

Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plans. We looked five care plans. They were up to date and included information such as details of a person's likes and dislikes, correspondence between health professionals and details of medical appointments.

None of the people or relatives we spoke with expressed concerns about safety. When we looked at the provider's September 2013 'Client Survey' we saw that 88% of the 52 people surveyed 'felt comfortable and safe with their carer.'

People and relatives spoke positively about care workers' skill and training. One person whose care included the use of a hoist, referred to their care worker as 'an expert in her field.'

We looked at the results of the provider's September 2013 'client survey'. We saw that 80% of the 52 people surveyed rated their care worker's professionalism as either 'excellent' or 'very good.'