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Inspection carried out on 20 February 2019

During a routine inspection

About the service:

Corinium Care Ltd provides live-in support to people in their own homes. At the time of the inspection 176 people across England and Wales received support from the service to meet their personal care needs.

The Care Quality Commission (CQC) only regulates the regulated activity of personal care; this inspection report only relates to the provision of personal care.

People’s experience of using this service:

• The majority of people and their representatives (the agency’s clients) told us they were satisfied with the care provided to them by their live-in carers. These people often had the same live-in carers and well-established relationships with them.

• These people spoke positively about their care provided by the live-in carers. Comments included: “It’s like having another daughter, we get on so well, that’s so important. I’m hugely lucky”, “[Name of carer] is excellent” and one person’s representative described the care saying, “It’s of the highest quality and standard.”

• Prior to and during the inspection we received less positive feedback from some people and their representatives. They had experienced more changes in live-in carers than they had initially expected or wanted, had experienced an unsatisfactory client and live-in carer match and had experienced a lack of standard in the quality of the live-in carer provided.

• A common area of dissatisfaction was the level of communication people experienced from the agency’s office, particularly at times when a new or replacement live-in carer was to be organised.

• In 2018 there had been several changes in managers responsible for managing the agency’s office and the provision of care, as well as changes in care managers and office staff. Changes in office staff had impacted on the agency’s ability to always communicate with the 'client' in a way which best suited them.

• Care managers assessed people’s needs and were key in helping the office staff understand the type of carer needed. They reviewed people’s support plans, communicated with the ‘clients’ and were there to resolve any communication or care issues. One person’s representative had experienced several changes in care manager, they said, “I can never speak to the same person twice.”

• Prior to our inspection senior managers had been aware of where the service needed to improve and during the inspection they openly discussed with us, and shared with us, their action plans to address this.

• We found many improvement actions had already started but which needed now to be sustained. These included improved guidance for staff working in the office (‘bookings’ and ‘client contact’ teams), changes to the recruitment and induction process for live-in carers and better arrangements for ensuring ‘client’ support calls were made where required.

• At the time of the inspection a regional manager was managing the office and supporting the organisation of all care support. The office teams were more settled and working well together; benefiting from the improved management support.

• We found improvement actions had also started, in relation to ensuring accident and incident records, mental capacity assessments and best interests meeting records and investigation records were completed and maintained. Also, to make sure consent, when obtained, was always recorded. Further training and discussion around investigation recording and accident and incident reporting and recording was to take place with care managers.

• These areas of improvement needed to be embedded in practice and then sustained to evidence that the provider’s actions had been effective in bringing about the required improvements for people.

Rating at last inspection:

Service rating was Good; inspection report published on 15 January 2018.

Why we inspected:

The most recent inspection, started on 20 February 2019, was brought forward due to information of concern received by CQC.

Follow up:

We will continue t

Inspection carried out on 12 October 2017

During a routine inspection

Corinium Care Limited is a domiciliary care agency that provides live-in care and support to people in their own homes. The agency has been involved in these services for many years. At the time of the inspection the service was providing live-in personal care to more than 180 people. The agency was providing care to people in different locations throughout England. These services were managed by the agency from an office in Nailsworth, Gloucestershire. One field service manager had recently been appointed to manage services for people in a small area in Kent where they lived. There were plans to extend this to the rest of England to provide more support locally for people and staff.

At the last inspection on 30 June and 3 July 2015, the service was rated Good. At this inspection we found the service remained Good.

Quality assurance procedures were used to monitor and improve the service for people and included them in developing their care and support. Feedback from people and their relatives or supporters was used to improve the service when their views were sought annually. Feedback about the handover between staff when there was a change in care worker had been highlighted and addressed. However, monitoring and auditing of systems could be improved to ensure accidents and medicine management records were complete. The service took immediate action to introduce a new checking system. We have made a recommendation with regard to the oversight monitoring of the service to ensure this will be sustained.

People were supported to maintain good health and be involved in decisions about their health. They were provided with individualised care and support. Staff had the knowledge and skills to carry out their roles and their training was updated annually. The live-in care workers knew people well and treated them with dignity and respect. Their changing care needs were monitored and the care plans were updated when required. People were positive about the care they received. One person told us, “The carers are always kind and efficient.” One relative commented in our survey, “Corinium has been a revelation. During the course of the last year, my parents, both of whom have dementia and receive 24 hour care, have received care from just four carers from Corinium. Each has been entirely appropriate for my parents' needs. I couldn't recommend them highly enough.”

Risks to people’s and staff safety were identified, assessed and appropriate action was taken. Staff had completed safeguarding adults training and knew how to keep people safe and report concerns. People’s medicines were safely managed. There were thorough recruitment checks completed to help ensure suitable staff were employed to care and support people. People were encouraged to make choices about their care and support and to be as independent as possible. People were protected by staff having regard to the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions.

Regular care manager meeting ensured concerns were discussed and procedures were updated in line with national and local changes in legislation and guidance. Care workers were well trained and supported by the agency office staff. Changes to their support in the field were planned with the employment of additional field care managers living in the same area. Healthcare professionals supported and monitored people’s health when required.

Further information is in the detailed findings below

Inspection carried out on 30 June and 3 July 2015

During a routine inspection

Corinium Care Limited is a domiciliary care agency that provides live-in care and support to people in their own homes. The agency has been involved in these services for many years. However, until early in 2015 the agency did not directly employ care staff and was not regulated by the Care Quality Commission (CQC). On 16 January 2015 Corinium Care Limited registered with CQC and began directly employing staff. This was the first inspection of the agency following their registration with CQC.

The inspection was announced. We gave the provider 48 hours advance notice of the inspection. We did this to ensure staff would be available to meet us at the agency’s office.

At the time of the inspection the service was providing live-in personal care to more than 150 people. The agency was providing care to people in different locations throughout England. These services were managed by the agency from an office in Nailsworth, Gloucestershire. People using the service, their families and Corinium Care Limited staff used the term ‘carer’ to refer to care staff. Therefore, when direct quotes are used in this report carer has been used. When we are referring to staff we have used the term care staff.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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 care and support from care staff they felt safe with. People were safe because care staff understood their role and responsibilities to keep them safe from harm. Care staff knew how to raise any safeguarding concerns. Risks were assessed and individual plans put in place to protect people from harm. There were enough skilled and experienced care staff to meet people’s needs. The provider carried out employment checks on care staff before they worked with people to assess their suitability.

The service was effective because staff had been trained to meet people’s needs. New staff received a thorough induction before providing care and support for people. Staff received support from managers through effective supervision and performance appraisal. Staff understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a caring and compassionate service from staff who knew them well. The provider and staff worked hard to provide a caring service in partnership with people using the service and their families. People were treated with dignity and respect. People were involved in planning the care and support they received. Staff protected people’s confidentiality and the need for privacy.

The service responded to people’s needs and the care and support provided was personalised. The provider encouraged people to provide feedback on the service received. The service made changes in response to people’s views and opinions.

People received a service that was well-led because the registered manager and other senior staff provided good leadership and management. The vision and values of the service were communicated and understood by staff. Staff understood their roles and responsibilities. Feedback on the quality of service people received was continually sought and any areas needing improvement identified and addressed.