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Carers 4 U Ltd Requires improvement

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 26 July 2019

During a routine inspection

About the service

Carers 4 U Ltd is a domiciliary care agency. It provides personal care, support and live in care services to adults and older people living within their own homes. Not everyone using the service may receive the regulated activity; personal care. 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. At the time of our inspection there were approximately 33 people using the service.

People’s experience of using this service

The provider had failed to ensure risks to people were appropriately assessed, recorded and managed by staff to avoid possible harm. The systems and processes in place for managing people's medicines were not always safe. Policies and procedures in place for reporting and recording accidents and incidents were not always robust to ensure peoples safety and were not conducive to learning from incidents. The providers electronic call monitoring (ECM) system was not robust or monitored to ensure people did not receive late or missed calls which potentially placed them at risk.

The provider failed to assess people’s capacity in line with the MCA and maintain a record of decisions made in people's best interests. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We have made a recommendation about ensuring the provider follows the principles of The Mental Capacity Act (2005).

Health and social care assessments were basic and lacked important information and guidance for staff. We have made a recommendation that the provider develops a more thorough and detailed tool for assessing individual’s needs, to ensure the staff team have a clear picture of individual’s needs, preferences and wishes and how best these can be met.

Peoples end of life care and support need and wishes were not assessed or documented as part of their plan or care. We have made a recommendation that the provider develops a detailed assessment tool for assessing individuals end of life care needs and wishes should people wish to do so and how best these can be met in line with good practice guidance.

The provider's quality assurance and monitoring systems had failed to identify the concerns we found at this inspection.

People and their relatives spoke positively about the care and support they received. Staff communicated well with people and had built good relationships with them. Professionals feedback was positive confirming good partnership working.

Safeguarding and whistleblowing policies and procedures were in place and staff were aware of how to keep people safe. Arrangements were in place to prevent the spread of infections. Appropriate recruitment checks took place before staff started work and there were sufficient staff available to meet people's needs. Staff had the skills and knowledge to support people appropriately. Staff were supported through induction, training and supervision.

People were supported to maintain a healthy balanced diet where this was part of the planned care. People and their relatives were involved in planning for their care and support. People had access to health and social care professionals as required and were supported to access community services.

Staff worked with people to promote their rights and understood the Equality Act 2010; supporting people appropriately addressing any protected characteristics. The service worked well in partnership with health and social care professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 31 January 2017).

Why we inspected

This was a planned inspection based on

Inspection carried out on 4 January 2017

During a routine inspection

This inspection took place on 4 January 2017 and was announced. Carers 4 U Ltd is a domiciliary care agency that provides personal care and support for people living in their own homes. At our last inspection of the service on 19 and 21 January 2016 we found a breach of legal requirements because the provider did not always keep up to date records of staff supervision sessions or annual appraisals.

At this inspection we found that the provider had taken action to make sure that records relating to staff supervisions and annual appraisals were kept up to date.

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 and associated Regulations about how the service is run.

People said they felt safe and staff treated them well. The service had appropriate safeguarding adults procedures in place and staff had a clear understanding of these procedures. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Procedures were in place to support people where risks to their health and welfare had been identified. Appropriate recruitment checks took place before staff started work. People’s medicines were managed appropriately and people received their medicines as prescribed by healthcare professionals.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Staff had completed an induction when they started work and they had received training relevant to the needs of people using the service. People’s care files included assessments relating to their dietary support needs. People had access to health care professionals when they needed them.

People were provided with appropriate information about the service. People and their relatives said staff were kind and caring and their privacy and dignity was respected. They had been consulted about their care and support needs and care plans were in place that provided information for staff on how to support people to meet their needs. People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken if necessary.

The provider recognised the importance of monitoring the quality of the service provided to people. They took into account the views of people using the service through satisfaction surveys. The provider carried out unannounced spot checks to make sure people were supported in line with their plans of care. Staff said they enjoyed working at the service and they received good support from the registered manager and care coordinators.

Inspection carried out on 19 January 2016

During a routine inspection

This inspection took place on 19 and 21 January 2016 and was announced. This was our first inspection at Carers 4 U Ltd. Carers 4 U Ltd is a domiciliary care agency that provides personal care and support for people living in their own homes. At the time of this inspection Carers 4 U Ltd was providing personal care to 23 people.

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 and associated Regulations about how the service is run.

A breach of legal requirements was identified. The provider did not always keep up to date records of the staff supervision sessions or annual appraisals. You can see the action we have asked the provider to take at the back of the full version of the report.

The provider did not have a call monitoring system in place that ensured staff turned up to support people or stayed for the allotted time to provide care. We saw the manager and a care coordinator contacting people using the service and staff throughout the course of our inspection, making sure people received care when they were supposed to. The provider was currently looking at the different call monitoring systems available with a view of adopting a call monitoring system for the service. We were not able to assess the impact of the lack of a call monitoring system on people's care as the system was not in place at the time of inspection. We will assess this at our next inspection of the service.

People said they felt safe and staff treated them well. The service had appropriate safeguarding adults procedures in place and staff had a clear understanding of these procedures. Appropriate recruitment checks took place before staff started work. Where appropriate people were supported to take their medicines as prescribed by health care professionals. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

The manager had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Staff had completed an induction when they started work and they were up to date with their training. People’s care files included assessments relating to their dietary support needs. People had access to health care professionals when they needed them.

People had been consulted about their care and support needs. Care plans and risk assessments provided information for staff on how to support people to meet their needs. People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken if necessary.

The provider took into account the views of people using the service through satisfaction surveys. The provider carried out unannounced spot checks to make sure people were supported in line with their care plans. Staff said they enjoyed working at the service and they received good support from the manager. They said there was an out of hours on call system in operation that ensured management support and advice was always available when they needed it.