Archived: Carefirst IW Limited

Not everyone using Carefirst IW Limited received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. This inspection was undertaken on 21and 23 November 2018 and was announced. We gave the provider 48 hours' notice of our inspection as we needed to be sure key staff members would be available. At the time of the inspection approximately 70 people were receiving a regulated activity from Carefirst IW Limited.

At the last inspection we rated the service good. At this inspection the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

A registered manager was in post. 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 and their families told us they felt safe. Staff understood their safeguarding responsibilities and knew how to prevent, identify and report abuse. Risks relating to the health and support needs of the people and the environment in which they lived, were assessed and managed effectively. There were safe medication administration systems in place and people received their medicines when required.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. There were sufficient numbers of staff to maintain the schedule of visits.

The provider and staff understood their responsibilities to protect people from the risk of infection. There was an infection control policy in place which was followed by staff and staff undertook training in this area.

Staff completed an induction programme and were appropriately supported in their work by the management team. People and their families described the staff as being well trained and they were confident in the staff’s abilities.

Staff and the management team, knew how legislation designed to protect people's rights affected their work. They always asked for consent from people before providing care.

People were supported to maintain good health and to access appropriate healthcare services when required. Staff were aware of people’s health needs and understand how people's medical conditions impacted their abilities.

People were supported to use technology and specialist equipment to meet their care needs and to support their independence where appropriate.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected.

People and when appropriate their families, were involved in discussions about their care planning and given the opportunity to provide feedback on the service.

The directors of the company were fully engaged in the running of the service. People, their family members and staff members told us they felt the service was well-led. The culture of the service was open and transparent. The directors of the company had a range of quality monitoring systems in place and the management team aimed to continuously improve the quality of the service they provided.

Carefirst IW provides personal care and support to people in their own homes. At the time of this inspection the agency was providing a personal care service to 70 people with a variety of care needs, including people living with physical frailty or memory loss due to progression of age. The agency was providing a service to people in the north and west of the Isle of Wight.

The agency 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.

We received positive feedback from people about the service. All people who used the service expressed great satisfaction and spoke very highly of the staff.

People told us they felt safe and secure when receiving care. Staff received training in safeguarding adults. Staff knew how to recognise and respond to abuse and understood their responsibility to report any concerns.

People’s risk assessments and those relating to their homes’ environment were detailed and helped reduce risks to people while maintaining their independence.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. There were sufficient numbers of care staff to maintain the schedule of visits. Staff told us they felt supported and received regular supervision and support.

People were cared for with kindness and compassion. People who used the service said their privacy and dignity were respected. People were supported to eat and drink when needed and staff contacted healthcare professionals when required. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices.

Staff were responsive to people’s needs which were detailed in care plans. People told us they had been involved in care planning and care plans reflected people’s individual needs and choices.

People felt listened to and a complaints procedure was in place. The provider sought feedback from people through the use of a questionnaire. The results from the latest survey were predominately positive.

Regular audits of the service were carried out to asses and monitor the quality of the service. The manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.

We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

We found the service was safe because staff kept accurate records of the medication people were taking. Some people needed support with their medication and the people we spoke with confirmed they got the level of help they needed. One person we spoke with, told us, 'Yes, they give me all my tablets, it's part of their routine, they don't forget.'

There were policies and procedures in place to safeguard people and the manager knew how and when to contact the local authority safeguarding team and make referrals if a person was potentially at risk. People told us they felt safe with the staff.

People's needs were met in ways which ensured their safety, such as two staff using a hoist together and risk assessments being completed.

Is the service effective?

Staff were able to undertake extra training and received on the job supervision and support. However, there was not a robust system in place to ensure all staff were up to date with all of their training. We have set a compliance action in relation to this and will follow this up.

People told us that they were happy with the care they received and felt their needs had been met. All gave positive feedback to us and comments included, 'They have quite a high standard of staff', 'I don't think anybody could do it any better' and, 'very, very pleased. We're 100% satisfied with them. We've got no complaints'.

The provider was flexible in their approach which meant people's individual needs could be met.

Is the service caring?

We found the service was caring in the way management and staff supported people in individual ways. One example of this was when staff looked after a person's pets so they could get the hospital treatment they needed. The manager and a senior staff member undertook additional hands on tasks which benefitted the person further, but was additional to the care plan. When people were admitted to hospital, the manager regularly contacted the hospital for updates on their health and to remind them that someone was thinking of them. One person we spoke with said, 'I'm really lucky to have them. They're all really good.'

Is the service responsive?

We found the service was responsive to people's unique and, at times, complex needs. We saw the care plan for one person was designed as a two week plan to take into account the person's home life and availability of their main carer. Records showed staff monitored people's health and contacted healthcare professionals when needed.

Is the service well-led?

We found the service was well led because the manager and staff sought the views of the people who used it and acted on any necessary or suggested improvements. The manager or senior staff undertook spot checks on staff at work and reviewed people's care and support needs.