1st Central Care Ltd

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this service. This key question has been rated requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person centred careand shortfalls in care planning.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity.

We received positive feedback from people about the service when it came to staff interaction.

People told us, “The carers are very nice and always leave him comfortable and clean when they leave,” and “They always ask if there’s anything else they can do before they leave, they get the washing out of the machine for me to dry.”

One person told us how the service had listened to their feedback, “When they first started coming there were men and women, but I didn’t like the men looking at me while I was being changed, there was no privacy. I only get women carers now”.

The provider treated people as individuals and took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Whilst record keeping was not at satisfactory level within the service, impact seemed to be minimal, people seemed happy with the level of input they had into their care and support.

People told us, “Yes, before they started, we met with [Registered Manager} and the social workers and agreed everything”. “[Staff member] came round to see us at 5pm and the care was started at 7pm. The plan was there and the carers started straightaway. [Staff member] has since called us to check everything is OK. They couldn’t be better.”

People also confirmed that they were involved in creating the care assessment with the provider, a person using the service told us “Yes, we carried out an assessment together.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

We found concerns with call times; these were not always delivered in a way that met people’s expectations. We found a significant number of calls that were late, we also found substantial amount of calls that were short in duration, as result visits ended early, alongside other concerns. When we asked people if call times were when they wanted them, we were told “No, they are not, especially in the morning.” Another person told us “No, they seem to be all over the place, we don’t have agreed timings.”

The provider did not always listen to and understand people’s needs, views and wishes.

Due to governance issues highlighted in other areas of this report we found that people did not always have their needs met or views and wishes understood. People did not always know who would be coming to offer care and support, one person told us, “We don’t get a call if they are running late, and we don’t get a rota, so we don’t know who is coming, or when”.

People also told us that an inconsistent staff team was a concern for them and led to issues, some comments we received included, “They are different every day. I have to write everything down that they should be doing”, “We get a variety; we never know who is coming” and “We get different people, and they don’t know what to do when they come.”

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Although staff generally reported that they were supported by the management team and could ask for assistance.We found little evidence of staff being adequately supported. For example, where spot checks were carried out documentation was routinely held by the staff member and management had no copy, this meant that agreed actions could not be followed up promptly or effectively. This affected the ability for the provider to support and enable their staff to carry out their duties effectively.

One staff member told us, “There could be more consistency in communication and follow-up on actions. At times, staff would benefit from clearer updates and more regular feedback.” They also told us, “More regular training and development opportunities could help staff feel more confident and supported.”

We also found evidence that call scheduling put pressures on the staff and led to issues with call times, for example we found a very high number of scheduled calls that had no allocated travel time between calls.

A staff member told us, “Travel time between calls can sometimes be tight.” Another told us, “Travel time is generally manageable, although at times it can feel slightly tight depending on scheduling and traffic. When this happens, it can create some pressure, but I always try to ensure care is not compromised.”