Simply Caring

Simply Caring is a domiciliary care agency. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care. Simply Caring is registered to provide personal care to younger and older adults who may be living with dementia, have sensory impairments, and / or physical disabilities. It provides personal care to 33 people living in their own houses and flats in the community. Additional services which are not regulated by the Commission were also provided, for example support with housework, companionship services and support to remain active.

At the last inspection in May 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated as Good:

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.

The service was well-led with person-centred values and a vision to provide high quality compassionate care. The provider and registered manager were open and approachable. The registered manager listened to feedback and reflected on how the service could be further improved. The service worked across organisations to ensure effective care, support and treatment.

People were protected from harm and discrimination. People’s human rights were protected because the code of practice in relation to the Mental Capacity Act 2005 (MCA) was understood and followed. People’s nutritional needs were met because staff followed people’s support plans to make sure people were eating and drinking enough and potential risks were known.

People were supported by staff who were kind and caring. All staff demonstrated respect for people through their conversations and interactions. Staff listened to people and gave them time to support their emotional needs. People were supported by a consistent staff group who knew them well. People’s privacy and dignity was promoted. As far as possible, people were actively involved in making simple choices and decisions about how they wanted to live their lives. People, and those who mattered to them were involved in decisions about their care. People were supported by compassionate staff in their final days.

People were protected from abuse because staff understood what action to take if they were concerned someone was being abused or mistreated. People felt safe with the staff providing their care.

Risks associated with people’s care and their living environment were effectively managed to ensure their freedom was promoted. People’s independence was encouraged and staff helped people feel valued by engaging in everyday tasks where they were able to.

The provider and management team wanted to ensure the right staff were employed, so recruitment practices were safe and ensured that robust staff checks had been undertaken. Staff underwent an induction, and there was ongoing training to meet people’s needs effectively. People were cared for by a consistent staff team they knew and trusted. People’s medicines were managed safely.

People were encouraged to live healthy lives, and their overall well being was promoted. People were supported to access health care professionals to maintain their health and wellbeing.

Safe infection control practices were followed. Staff had access to personal protective equipment and had received training in minimising cross infection.

Policies and procedures were in place if people had a concern or complaint. Feedback was gathered from people to continue to improve the service. Complaints and incidents were reflected upon to ensure ongoing improvement. The registered manager / provider promoted the ethos of honesty and admitted when things had gone wrong. The service kept abreast of changes to maintain quality care.

Staff adapted their communication methods dependent upon people’s needs, for example simple questions and information was given to people with cognitive difficulties.

People received care which was responsive to their needs. People and their relatives were encouraged to be part of the care planning process and to attend or contribute to care reviews where possible. This helped to ensure the care being provided met people’s individual needs. However, care plans required further developing to include more detail on people’s preferences and routines.

People were treated equally and fairly and some staff had received training in equality and diversity. The management team were also considering how this area could be further developed across policies, assessments and care plans.

We recommend care plans are developed further to reflect people’s diverse needs, care, routine and preferences.

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.

The inspection was undertaken over a four day period, 27 May, 1, 2 and 7 June 2016 and included visits to the office, staff interviews and visits to people in their own home. At the time of this inspection 45 people were using the service, of which 36 were receiving support with their personal care needs. Our last inspection took place in May 2014 when it met the regulations we looked at.

People, their relatives and staff told us the service was well-led. One person said, “I have to tell you, I find them absolutely marvelous. Their communication with us is excellent.” The registered manager and providers had a clear vision of their aims and objectives for the service and how they wished the service to support people. The registered manager said, “We don’t just want to care for people, we want to improve their quality of life.”

People told us they felt safe with the staff when receiving care. They said they have a regular staff team whom they have come to know well: people described the staff as ‘friends’. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy.

Risks to people’s health and safety had been assessed and regularly reviewed. These assessments included information about how to minimise the chance of harm occurring to people and staff. The service supported some people to take their medicines. The care plans provided information about each person’s medicines and why they were prescribed. People told us the staff supported them safely and they received their medicines as prescribed.

The service employed sufficient numbers of safely recruited and well trained staff to meet people’s needs. People told us they had never had a missed call, and if the staff were going to be late they always received a phone call to notify them. The providers and registered manager reviewed staff performance through observation, spot checks and supervisions.

People and their relatives were very positive about the way staff supported them. Each person we spoke with told us their care staff were kind and compassionate. One person said, “I’ve had the same girls for years, they’re all very good and very friendly”. People told us staff do ‘little extras’ for them, such as posting letters or bringing milk. One person said, “They are so kind, they bring things from the village for me, they help in any way they can.” A relative told us, “Simply Caring provided compassionate, reliable daily care and support. Without Simply Caring I do not believe he, or we, as a family would have managed the care he so wanted Mum to receive.”

Staff spoke about people with affection. One staff member said, “I love helping people. I love the feeling of a job well done” and another said, “It’s a really good job, I love it.” People told us they were treated with respect and kindness and staff respected their dignity. The registered manager said the service cared for and supported people to remain at home through illness and at the end of their lives. Staff received end of life care training and they told us they were proud to be able to continue to care for people at this time. One member of staff said, “It’s a real privilege to care for someone at the end of their life”.

Care plans were developed with each person and people told us they had received a copy. These plans described the support the person needed to manage their day to day needs. Staff knew people well and were able to tell us how they supported people. Staff recorded the care they provided at each visit and we saw these records were detailed and clearly written. One person told us, “They help me in the way I want. Nothing is too much trouble for them. I’m very pleased.” People told us a senior member of staff and the registered manager visited regularly to review and discuss their care needs.

The service was flexible and responsive to changes in people’s needs. One person told us the service had provided extra visits while their family was away. One relative told us, “They were always flexible and were able to provide additional support at very short notice. If it wasn’t Simply Caring my parents would never have sustained such a level of independence for so long. They went above and beyond.”

Regular staff meetings enabled staff to discuss ideas about improving the service as well having a theme topic each month such as safeguarding people from abuse. Staff told us the registered manager and providers were very approachable and were always available. Comments included “I can pop in to the office at any time for a chat” and, “it’s a unique company and a unique team. We all get on so well”.

People and their relatives felt able to raise concerns or make a complaint if something was not right. They were confident their concerns would be taken seriously. The service had received two complaints in January 2016. These were investigated by the registered manager in line with the service’s policy. The outcome of the investigations were recorded and discussed at the following month’s staff meeting. Records showed the complaints were resolved to the complainants’ satisfaction.

Audits were carried out to monitor the quality of the service. Unannounced checks to observe staff’s competency and interaction with people were carried out on a regular basis. The service sought regular feedback from people who used the service. The registered manager had sent questionnaires people receiving a service in October 2015 and the feedback from these questionnaires showed people were very satisfied with the care and support they received. This was reflected in the feedback we received from people, staff and healthcare professionals to the questionnaires we sent prior to this inspection.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. If you want to see the evidence to support our summary please read the full report.

Is the service safe?

People told us they felt safe. People told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

There were enough qualified, skilled and experienced staff to meet people's needs. We found staff were competent in their role and understood the needs of the people they cared for.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. We saw people's care plans were up to date and reflected their current needs. There were good arrangements in place to gain consent from people who were able to give it.

People we spoke with told us they had regular staff visiting them and they knew the time staff were going to arrive. They told us the service kept them informed if there were any changes to the timing of visits or if staff were running late.

Is the service caring?

During our inspection we visited four people in their own homes and spoke with the two people on the telephone. People we spoke with told us they were happy with the service provided by Simply Caring. Comments from people included: 'I am very pleased with the service', 'they are excellent ' good staff' and 'they [staff[ are all very nice, very kind and very helpful'.

People using the service and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were taken on board and dealt with.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People we spoke with knew the staff who worked in the office and indicated to us they would feel comfortable raising a complaint if they needed to.

The service was flexible and could be adapted to meet people's needs and wishes. People told us staff would always complete extra duties for them if they requested it. One person told us 'They do anything I want them to do'.

Is the service well-led?

The service had a quality assurance system, and records showed that opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and demonstrated a good understanding of the ethos of the service. This helped to ensure people received a good quality service at all times.

On the first day of our visit we visited the registered office of Domiciliary Care - 12 Erme Court (Simply Caring) and spoke with the registered manager, the senior carer and one other care staff member. On the second day we visited people in their homes and spoke to people over the telephone that was in receipt of personal care from Simply Caring.

We read the records and care plans of six people, visited five people in their homes and spoke to five people over the telephone. We spoke with three relatives and we spoke with two of the care staff.

We found people were being asked for their consent before receiving day to day care and understood the terms on which care was to be delivered.

We found people were having their care needs met and people felt the care was safe and appropriate to their needs.

We found that Simply Caring was carrying out effective infection control and cleanliness ensuring people were protected from infection as a result.

We found that staff were employed using appropriate systems to keep people safe and there were enough staff to deliver the care Simply Caring are committed to at this time. We however, were concerned that staff's training and knowledge was not sufficiently up to date. This may mean that people's care could be unsafe.

We found there were concerns in respect of the safe storage and transportation of people's data and some of the records were not being kept to a level which ensured care was safe and appropriate at all times.

All of the people we spoke with gave positive feedback about the service and said that care staff respected their choices about the way that care was delivered. All of the people we spoke with said that they felt safe using this service and knew what to do if

they had any concerns. They had all been visited by a senior care worker to review the care they were receiving and to check if there were any issues.

The people we spoke with confirmed that the care workers supported and encouraged them to maintain as much independence as possible. They told us that care staff had asked them how they liked to be addressed and had acted in accordance with their

responses.

They were confident that staff had the appropriate knowledge and skills to meet their needs and described the care workers as professional, well mannered, thoughtful, friendly and caring.

One person said "I get the help that I want and it's all going well". Another person said that the care staff were all "very friendly and listen to you". These comments reflected the overall feedback we received from people using the service.