Archived: Care UK Specialist Care at Home

Care UK Specialist Care at Home is a service that provides personal care to people in their own homes. It specialises in the care of people who live with dementia. Not everyone who uses the service receives personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service was providing personal care to 90 people at the time of the inspection, most of whom were living with dementia.

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

People and relatives said they or their loved one felt safe with staff. There were enough safely recruited staff, including agency staff, to provide the care people needed. Staff understood their responsibilities for safeguarding people. Risks to people’s safety and wellbeing were assessed and managed. Staff supported people safely with medicines.

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.

A holistic assessment of people’s needs formed the basis of their bespoke care plans. People were confident in the abilities of their staff. Staff felt well supported through training and supervision. People were supported to manage their health needs. Staff referred promptly to the appropriate professionals where there were concerns about a person’s wellbeing.

People and relatives praised of the manner of care staff, who treated them with dignity and respect. Wherever possible, people had a small team of staff for continuity. Staff promoted people’s independence and supported them to have their views heard.

People and their relatives were happy with their care. They knew how to raise complaints or concerns and felt comfortable to do so. The service had received compliments about the way care had helped people’s lives improve. Complaints were investigated and acted upon.

There was good communication. Staff were enthusiastic about their roles and shared the service’s ethos of person-centredness. Things that went wrong were treated transparently and as a learning opportunity. Quality assurance processes included regular audits and spot checks. Appropriate action was taken if shortcomings were found.

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 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The service is a domiciliary care service that provides personal care in their own homes to adults who live with dementia. At the time of our inspection there were 106 people using the service. The service is required to have a registered manager. The most recent registered manager had left in the autumn of 2016. Their replacement, who had worked at the service for a number of years, was already in post and had applied to register with CQC. 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.

People had the care and support they needed, which was described in their clear and thorough care plans. People praised the care and support they and their relatives received as exceeding their expectations and boosting their sense of wellbeing. They valued the quality of the service. Health and social care professionals who provided feedback were all very positive about the service and the results it achieved. Some professionals complimented the service on how it worked well with people who had challenging and complex needs. As far as possible people were encouraged to maintain their independence, and their care plans promoted this.

The service manager said the service tended to attract new referrals through word of mouth rather than by advertising. This was confirmed by some of the health and social care professionals we heard from, who told us the service was known as a very good service and that they were glad to direct people towards it.

People’s needs were assessed thoroughly before they started to receive a service, so staff could be sure it would be able to support them in the way they needed. Following this assessment, the service matched people with compatible and suitably skilled staff who worked in their locality. Rosters were organised so people received care from a small team of regular staff who understood their needs and could get to know them.

The service was flexible and responsive to people’s individual needs and preferences, finding creative ways to enable people to maintain social contact and live as full a life as possible. People’s care was not rushed, enabling staff to spend quality time with them. Staff had flexibility to accommodate people’s day-to-day choices and they viewed people holistically rather than focusing purely on tasks that needed completing. Relatives commented on how the service was proactive in contacting them to suggest improvements to people’s care and support, such as letting them know when staff became available to visit at their preferred time.

People and their relatives were treated with kindness, compassion and sensitivity. Their privacy and dignity were respected. People and their relatives valued their relationships with their staff team.

People’s rights were protected because the staff acted in accordance with the Mental Capacity Act 2005. People and their relatives were involved in decisions about their care. Staff understood how to find out about and meet people’s preferences, and were innovative in suggesting additional ideas that people themselves might not have considered. Consequently, some people were now getting care they needed but might previously have resisted.

People were given the information and explanations they needed, at the time they needed them. People and relatives told us they were kept informed of any issues, and were easily able to contact the service if they needed to.

Where people needed support with health conditions, care plans contained information for staff about the condition and any signs and symptoms they should be aware of. Relatives told us the service contacted health professionals promptly if the need arose, and kept them informed of this.

Peoples’ medicines were managed and administered safely. People’s care records contained clear information about their medication needs, including arrangements for collecting medicines from pharmacy and whether staff were responsible for administering prescribed medicines.

Where people received support with meal preparation and eating and drinking, people and their relatives we spoke with were happy with the support they received. Staff offered them choices and respected their preferences.

Risks to people’s personal safety and to staff had been assessed. Risk assessments protected people, whilst promoting their freedom and independence. They were signed and dated and up to date.

People were protected against the risks of abuse and neglect. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. Where concerns were raised, appropriate action was taken to address them, including working with the local authority safeguarding team to investigate concerns and taking disciplinary action where necessary.

People’s concerns and complaints were encouraged, investigated and responded to in good time.

People involved in accidents and incidents were supported to stay safe and action had been taken to prevent further injury or harm.

People were supported by sufficient skilled and competent staff. Safe recruitment procedures, including Disclosure and Barring Service checks and references, ensured that people were supported by staff who were of good character and suitable for their role.

Staff were supported through regular training and supervision to be able to perform their roles safely and effectively. Staff told us the office and out-of-hours on call staff were helpful, in the event they needed to contact them.

Staff meetings took place regularly, and learning from incidents, complaints and safeguarding investigations was shared with staff. Staff also received the provider’s ‘Our Voices’ newsletter for staff, and one of the care workers attended ‘Our Voices’ meetings as the service’s representative.

Systems were in place to monitor the quality of service being delivered. The provider is a large organisation with a regional structure; it provided corporate and regional support, including monitoring trends and auditing the service at least annually. People’s experience of care was monitored through the provider’s customer satisfaction surveys. Staff from the office periodically contacted or visited people and their relatives to check they were happy with the service and whether anything needed to be changed. Where scope for improvement was identified, this was identified on the service’s action plan and changes were made.

The service manager had notified CQC about significant events. We use this information to monitor the service and ensure they respond appropriately to keep people safe.