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Inspection carried out on 18 February 2019

During a routine inspection

About the service:

Christchurch Care is a domiciliary care agency that was providing personal care to 40 older adults living in their own homes at the time of the inspection.

People’s experience of using this service:

People described the care as safe and consistently spoke positively about the caring, friendly, kind nature of both the management and staff team. People were supported by enough staff who provided flexible, responsive care. Staff recruitment checks were robust and ensured staff were suitable to work with vulnerable older people. Staff induction, on-going training and support enabled them to carry out their roles effectively.

Risks to people, including health risks, environmental risks and risks of preventable infection were regularly assessed and understood by staff. When actions were in place to minimise avoidable harm they were respectful of people’s freedoms and choices.

Staff were responsive to people’s changing care needs and pro-active in arranging healthcare or specialist assessments when needed. People had their medicines administered safely by trained staff who regularly had their competencies checked.

Care and support plans were person centred and recognised people’s cultural and spiritual needs and lifestyle choices. People were protected from discrimination as staff had completed equality and diversity training and demonstrated a positive, non-judgemental attitude. Care plans were reviewed regularly with people who told us they felt involved in their care decisions. People had an opportunity to be involved in end of life care plans. When people received end of life care the service worked in partnership with other professional agencies to ensure care was responsive and maintained a person’s comfort.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Leadership of the service created an open, positive culture which enabled people, their families and the staff to share ideas, concerns and feedback. Audits, quality assurance processes, accidents and incidents were seen as an opportunity for reflective learning and service improvements.

A full description of our findings can be found in the sections below.

Rating at last inspection: The service was rated ‘Good’ at our last inspection carried out on the 16 August 2016.

Why we inspected:

This was a planned inspection based on previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Inspection carried out on 16 August 2016

During a routine inspection

The inspection took place on 16 and 17 August 2016 and was announced. The service provides personal care to adults of which the majority are older people living in their own homes. At the time of our inspection there were 19 people receiving a service from the agency.

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.

Risks to people were assessed and reviewed regularly, however care plans did not consistently provide a detailed description of the actions needed to reduce an identified risk. Staff understood what they needed to do to minimise risks to people. We discussed this with the registered manager who told us they would review the plans associated with identified risk and ensure sufficient detail was available in the care plans.

Accidents and incidents were recorded and reviewed and any necessary actions had been taken to help reduce further risk.

People were involved in decisions about the risks they lived with and supported in ways that ensured their freedom of choice was respected. A business continuity plan was in place and included managing risks associated with extreme weather, financial issues and absence of the registered manager.

People were supported by staff that had been trained in how to recognise signs of abuse and knew the actions they needed to take if they suspected abuse. People were supported by staff who had been recruited safely and all the necessary checks had been completed

People were supported by enough staff to meet their agreed requirements and by staff whom they were familiar with. Staff understood people’s individual communication needs and people and their relatives felt involved in decisions about their care. Information about advocacy services was available to people if needed..

People had their medicines stored and administered safely by staff that had been trained and regularly had their competencies checked.

People received care from staff who had received an induction and on-going training that provided them with the skills and knowledge to carry out their roles effectively. Staff were supported in their roles,received regular supervision and had opportunities for personal development.

Staff understood the need to seek people’s consent before providing care. When people had been assessed as not having the mental capacity to make a decision then a best interest decision had been made in line with the principles of the Mental Capacity Act 2008.

People were supported by staff who understood their eating and drinking requirements and who also supported people to access health care when needed.

People, their families and other professionals with knowledge of the service described all the staff as caring, punctual and described the service as personal. People had their dignity and privacy respected. Staff had a good knowledge of people and were able to tell us about their life histories, family and friends involved in their lives as well as events that were important to them.

People had care plans that were individual and centred around how the person wanted to be supported. Descriptions of how to support a person included details of the person’s level of independence. Reviews of care and support needs happened in people’s homes and were shared with families if people wanted them to be. This meant that people were being supported by staff who had the knowledge and confidence to respond to peoples changing needs.

A complaints process was in place and people felt if they needed to use it they would be listened too.

Staff spoke enthusiastically and were positive about the organisation and the registered manager, felt appreciated