Archived: Care 1st Homecare

We spoke with 12 people who use the service, and tried to speak with a further eight people. We inspected 11 care records of which six had been randomly selected by the provider. We visited six people in their own homes. We spoke with nine relatives. We spoke with nine members of staff and tried to talk with a further four staff.

People who use the service told us they liked most of the care staff and found them to be caring and kind. One person told us 'the girls themselves are super'. Another person said 'I have good carers and they are the same ones most of the time'. People we spoke with told us they felt the care provided respected their privacy and dignity.

Three relatives told us the care staff were very good, kind and mostly reliable. Staff knew what they were doing and how to do it. They felt their relatives were safe. Two relatives and one person using the service had 'fairly regular carers'. Another person and their relative told us 'we're wholly satisfied with the courtesy of the staff; by and large they are very good. They seem to recruit good quality staff'.

Two people who use the service and one relative told us that they do not get regular care staff. One member of staff told us 'there is not always time to read the care plan'. Two people told us they did not feel the care staff were knowledgeable and that they had experienced poor care to the detriment of their health and wellbeing.

One member of staff and a relative told us, 'people are positive about the staff but not the office', and that 'talking to the office is like talking to a brick wall'.

All the people we spoke with told us that staff did not wear identification badges (ID) and sometimes communication breaks down, potentially putting people at risk of harm. In five of the records of unannounced checks on staff delivering care, we saw the service supervisors had recorded that staff were not wearing their ID badges to enable people to recognise staff and be sure they could feel safe with them.

Two people told us 'communication is poor'. Two people also expressed concern that the late and missed visits they experienced were not as well managed as expected, with little communication from the service about them.

Two office based staff told us there is no system to check messages had been passed on or to check they had been followed up. Both staff told us communication is verbal or by email between office staff but no records are kept to ensure a person has followed up on the message. They told us sometimes an entry may be made in the individual care log, held electronically, for each person using the service.

The service provider acknowledged that communication with a dispersed workforce is difficult and recently the agency had been using technology, for example email and SMS text messaging, more to aid communication. A supervisor we spoke with told us, 'clients talk about communication, and we've been working to improve that'. She also told us 'like every provider we do have our problems. We do provide quality care and we do our best'.

All the people we spoke with and their relatives told us they are concerned about communication. One relative told us they had called the office repeatedly to speak with a supervisor but their calls had never been returned. Another person told us that clear messages left by them about their relative's care had been ignored. This had a detrimental effect on their relative. All the people we spoke with did not feel the service responded quickly to requests.

Nine out of ten people we spoke with told us visits had been missed and the care records confirmed this. The client contact logs we saw for two people showed there had been problems with care staff missing visits. There was no record in the log of any calls to the office or to staff on these days.

Two members of staff told us that sometimes people have their visit(s) for a specific day missed and that visits are more often missed at the weekends. They told us there are less missed visits in the week but they do still happen. People we spoke with told us 'the carers don't ring if they are going to be late'. The inspectors were told by three separate members of staff that there was not always sufficient travel time between visits to people who use the service and this had resulted in some late visits. They told us "the agency asks us to call if we're late but they don't tell the client'.

One person and their relative told us 'I can't rely on who is coming or even the time they're coming. I can't go out or leave them doing it because they don't come in enough times'.

The four staff we spoke with had a good knowledge of the individual people to whom they provided care. They told us they mostly went to the same people but would see other people who use the service to cover for sickness and holidays. They probably would not have visited them before.

One member of staff told us the care plans were not always updated to enable them to be clear about the individual's care needs and how to meet them. Information about equipment to assist people was not always available.

We spoke with 12 people who use the service, and tried to speak with a further eight people. We inspected 11 care records of which six had been randomly selected by the provider. We visited six people in their own homes. We spoke with nine relatives. We spoke with nine members of staff and tried to talk with a further four staff.

People who use the service told us they liked most of the care staff and found them to be caring and kind. One person told us 'the girls themselves are super'. Another person said 'I have good carers and they are the same ones most of the time'. People we spoke with told us they felt the care provided respected their privacy and dignity.

Three relatives told us the care staff were very good, kind and mostly reliable. Staff knew what they were doing and how to do it. They felt their relatives were safe. Two relatives and one person using the service had 'fairly regular carers'. Another person and their relative told us 'we're wholly satisfied with the courtesy of the staff; by and large they are very good. They seem to recruit good quality staff'.

Two people who use the service and one relative told us that they do not get regular care staff. One member of staff told us 'there is not always time to read the care plan'. Two people told us they did not feel the care staff were knowledgeable and that they had experienced poor care to the detriment of their health and wellbeing.

One member of staff and a relative told us, 'people are positive about the staff but not the office', and that 'talking to the office is like talking to a brick wall'.

All the people we spoke with told us that staff did not wear identification badges (ID) and sometimes communication breaks down, potentially putting people at risk of harm. In five of the records of unannounced checks on staff delivering care, we saw the service supervisors had recorded that staff were not wearing their ID badges to enable people to recognise staff and be sure they could feel safe with them.

Two people told us 'communication is poor'. Two people also expressed concern that the late and missed visits they experienced were not as well managed as expected, with little communication from the service about them.

Two office based staff told us there is no system to check messages had been passed on or to check they had been followed up. Both staff told us communication is verbal or by email between office staff but no records are kept to ensure a person has followed up on the message. They told us sometimes an entry may be made in the individual care log, held electronically, for each person using the service.

The service provider acknowledged that communication with a dispersed workforce is difficult and recently the agency had been using technology, for example email and SMS text messaging, more to aid communication. A supervisor we spoke with told us, 'clients talk about communication, and we've been working to improve that'. She also told us 'like every provider we do have our problems. We do provide quality care and we do our best'.

All the people we spoke with and their relatives told us they are concerned about communication. One relative told us they had called the office repeatedly to speak with a supervisor but their calls had never been returned. Another person told us that clear messages left by them about their relative's care had been ignored. This had a detrimental effect on their relative. All the people we spoke with did not feel the service responded quickly to requests.

Nine out of ten people we spoke with told us visits had been missed and the care records confirmed this. The client contact logs we saw for two people showed there had been problems with care staff missing visits. There was no record in the log of any calls to the office or to staff on these days.

Two members of staff told us that sometimes people have their visit(s) for a specific day missed and that visits are more often missed at the weekends. They told us there are less missed visits in the week but they do still happen. People we spoke with told us 'the carers don't ring if they are going to be late'. The inspectors were told by three separate members of staff that there was not always sufficient travel time between visits to people who use the service and this had resulted in some late visits. They told us "the agency asks us to call if we're late but they don't tell the client'.

One person and their relative told us 'I can't rely on who is coming or even the time they're coming. I can't go out or leave them doing it because they don't come in enough times'.

The four staff we spoke with had a good knowledge of the individual people to whom they provided care. They told us they mostly went to the same people but would see other people who use the service to cover for sickness and holidays. They probably would not have visited them before.

One member of staff told us the care plans were not always updated to enable them to be clear about the individual's care needs and how to meet them. Information about equipment to assist people was not always available.

They also told us they feel care is provided in a way that respects their privacy and dignity and enables them to be as independent as possible.

People we spoke to and their relatives told us that staff always put the people who use the service at the centre of their care and seek to respond to the individual's needs and wishes.

People we spoke to told us:

"The staff are genuinely caring, both in the office and those who visit".

"The staff are very efficient, competent and confident in their work". They always ask me what I want and do it".

'There is nothing to complain about the service is good'.