This comprehensive inspection took place on 10 November 2017 and was announced.
Falcare is a domiciliary care agency that provides personal care and support to younger adults and older people in their own homes. At the time of our inspection 32 people were receiving a personal care service. Some people had short visits at key times of the day to help them get up in the morning, go to bed at night and give support with meals. Other people received longer visits to support them with their daily lives and other people received a 24 hour a day supported living service. A supported living service is one where people live in their own home and receive care and support to enable people to live in their own home as independently as possible. 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 and support.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy
The service had a registered manager 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.
We observed staff demonstrated an exceptionally caring, compassionate and kind attitude towards people. Staff exceeded what was expected of them routinely. On relative said; “They are amazing”. Feedback about the service from everyone we spoke with was positive. People were supported to achieve their goals and ambitions and staff went the extra mile to support them. Respect for privacy and dignity was at the heart of the service’s culture and values. People’s support was completely personalised and tailored to their individual needs. There was a strong focus on protecting people’s human rights and ensuring they did not experience discrimination in any form. People received compassionate care and attention at the end of their life.
There were numerous examples of how staff provided individual support for people who were supported by Falcare, to take part in activities and follow their interests. We found this had a hugely positive impact on peoples lives. People were supported to maintain their hobbies and interests and to try new experiences. Innovative ways were found to help people remain in their own home and live as independently as possible. Staff knew the people they supported very well and this enabled them to build strong, and supportive working relationships.
Staff were available to ensure people received continuous, attentive and discreet care and support. Staff responded to people’s choices as well as meeting their care and support needs in a way that suited the person. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible
People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age..
People had their care visits as planned. Staff arrived on time and stayed for the allotted time. Nobody reported any missed visits. People confirmed there was a stable staff team and that care was provided by familiar faces. Staff told us that travel times were sufficient, so they were not rushed.
Care records were organised, detailed, and personalised. These comprehensive care records were regularly updated and reviewed with involvement from people and their families. Comprehensive daily logs were kept which were reviewed and audited by managers to that there was a good oversight of the care provided.
Accidents and incidents were accurately recorded and reported and any lessons learned were shared with staff. The service learned from any mistakes and used these as an opportunity to raise standards. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.
People were supported by staff who were trained to carry out their roles effectively. Staff received mandatory training as well as training which was tailored to the needs of those they supported. All staff received an induction and an on-going programme of supervision and appraisal. Staff felt well supported. There were regular team meetings which were well attended.
People told us they felt safe. People were protected by staff who knew how to recognise and report signs of abuse or mistreatment. People were supported by staff who had undergone a thorough recruitment process to ensure they were suitable to work with people who were vulnerable. Staff had received training in health and safety, infection control and moving and handling to ensure their practices were safe. Some people using the service required prompting and assistance with their prescribed medicines. Staff had received training on medicines management which was regularly reviewed. Staff completed MAR (medicine administration records) as necessary and these records were audited by managers.
People had risk assessments in place to cover various aspects of their daily lives. People were encouraged to be independent and to take everyday risks. There was guidance for staff on how to manage identified risks to people.
Staff were truly valued by managers. Their contributions were appreciated and there were a range of incentives for employees. Morale was very high and staff supported each other. Staff spoke highly of the managers and felt they were approachable. Staff told us there was an open door policy. There were policies and procedures in place to protect staff. For example there was a lone working policy in place which staff were aware of and worked to.
There were effective quality assurance arrangements at the service in order to raise standards and drive improvements. The service’s approach to quality assurance included completion of an annual survey. The results of the most recent survey had been extremely positive. There was also a system of audits to ensure quality in all areas of the service was checked, maintained, and where necessary improved. Feedback on the service was actively sought.
There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.