Archived: HomeLife Carers (Okehampton)

Homelife Carers (Okehampton) is a domiciliary care agency. It provides personal care to people living in their own houses in the Okehampton area. Not everyone using the service receives 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. At the time of our inspection 32 people were receiving ‘personal care.’

People’s experience of using this service and what we found

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

The service provided safe care to people. One person commented: “I feel very safe indeed.” Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff provided care that was kind and compassionate.

There were sufficient staff to meet people’s needs. People confirmed that staffing arrangements met their needs. However, due to staff sickness and travel times late visits did occur and rotas often had gaps which people found difficult. People did say that things had improved since the new manager came into post, citing communication from the office was much better when changes to rotas were needed or a carer running late. People confirmed staff always stayed the allotted time.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

Staff spoke positively about communication and how the new manager worked well with them and encouraged their professional development.

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.

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

Rating at last inspection: Good (report published in August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homelife Carers (Okehampton) on our website at www.cqc.org.uk.

Follow up

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

HomeLife Carers (Okehampton) is registered to provide personal care, primarily to support older people who want to retain their independence and continue living in their own home. Staff visit people living in the areas of Cheriton Bishop, North Tawton, Okehampton, Hatherleigh and Holsworthy. In March 2017, the provider took over another care agency, so increased the numbers of people they cared for and their staff team. At the time of the visit approximately 100 people were receiving a personal care service.

The service did not currently have a registered manager. The previous branch manager had left due to ill health. A new branch manager was appointed in October 2016, they have now successfully completed their induction and probation period, and were in the process of registering with the Care Quality Commission. The provider notified us about those changes. A registered manager is a person who has registered with the CQC 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 received their medicines safely and on time because medicines systems had improved. All staff had competency assessments to check their medicines management skills and knowledge, which were regularly reassessed. Recruitment processes had improved to ensure people were cared for by suitable staff. The provider had robust recruitment checks which were completed in full to ensure fit and proper staff were employed. Any unexplained gaps in employment were identified and followed up at interview. Police checks, checks of qualifications and identity and references were obtained on all staff applicants to ensure staff recruited were suitable to work with people who use care and support services.

People felt safe using the service and said it was reliable. People knew care staff well and said they usually arrived on time and stay for expected length of time. They let them know if they were running late. Staff knew about the signs of abuse and worked closely with health and social care professionals to implement measures to safeguard people. Staff were aware of risks and risk assessments identified steps staff needed to take to promote people’s safety and welfare.

Staff had the skills and training needed to carry out their role and undertook regular training relevant to needs of people they cared for. People confirmed staff sought their consent before providing any care. Where people lacked capacity, staff demonstrated a good understanding of the Mental Capacity Act (MCA) (2005) and how this applied to their practice.

Staff developed positive and caring relationships with people. People confirmed staff respected their privacy and treated them with dignity and respect. People's care was individualised to their needs. People were consulted and involved in decisions about their care. People signed their care plans to confirm they agreed with their content.

People, relatives and professional feedback consistently showed the service was person centred and responsive to people’s individual needs and preferences. This enabled people to remain as independent as possible. Care staff were motivated, people mattered and staff spoke with kindness and compassion about the people they supported.

People's care plans were personalised, detailed and comprehensive and described positive ways in which staff could support them. People knew how to raise any concerns or complaints and felt confident to do so. Action was taken in response to make improvements.

The culture of the service was open; people, relatives, professionals and staff were very positive about the leadership of the agency. Care and office staff worked well together as a team. The provider promoted good standards of care and developed the staff team. The provider had a range of quality monitoring systems which included spot checks, regular review meetings, audits and an annual survey. The service made continuous improvements in response to their findings.

The service has improved and was meeting all the requirements of the regulations.

When we did our planned inspection of HomeLife Carers (Okehampton) on 17 October 2013 people told us that they did not receive any care that they had not consented to. However, not all care workers had been trained in the Mental Capacity Act 2005, which provides legal safeguards where people do not have the capacity to make decisions with regard to decisions about their welfare. This meant that the arrangements for gaining consent to care and treatment did not protect people who might not have capacity to make that consent. This could lead to their human rights not being upheld.

We received a plan of how the agency intended to ensure that care workers were adequately informed about the Mental Capacity Act 2005 and how that training would be ongoing.

The agency have now confirmed that those actions are completed.

We spoke to seven of the 43 people currently using the service, visiting one. We read 42 of the agency's client feedback surveys dated July and August 2013. We spoke to five care workers including a Community Team Leader for the agency. We also spoke to the registered manager and representative of the provider organisation.

People told us, "They are fine. Some are very experienced but all are alright"; "Not too bad"; "Punctual, nice girls" and "Very professional." People were satisfied with the care worker's timekeeping and the care they delivered.

People, or their representatives, were consulted about all aspects of their assessment, care plan and care delivery. However, some care workers had not received training in the Mental Capacity Act 2005. This might compromise their understanding of the legal safeguards which protect people unable to consent to care.

There were enough staff employed to meet people's individual needs. Those staff were trained and supported in their work. External advice was sought, for example, for moving a person safely.

People commented about the service through questionnaires, meetings with care workers and care coordinators and using the agency's complaints procedures. Comments and concerns were followed up robustly.

Each person told us that care workers wore the protective clothing for hygiene reasons and we confirmed that infection control training was provided and protective clothing always available for staff use.

People we spoke with who received a service from the agency said that their care and welfare needs were being well met. We were told by people that staff supported them appropriately with daily living tasks, including personal care and meeting nutritional needs.

People confirmed that they felt safe and supported by staff from the agency. They had no concerns about the ability of staff to respond to safeguarding concerns. They felt that their human rights were upheld and respected.

People we spoke to said that staff were supportive and helpful. Staff were able to speak confidently about the care practices they delivered and understood how they contributed to people's health and wellbeing.

People confirmed that the agency sought their views about the quality of the service they received and that this information was sought by questionnaires.