Good Neighbour Care

Not everyone who used the service received 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.

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

All the people we spoke with who used the service told us they were happy with the care they received and would recommend the service to others.

People were supported by staff who knew how to protect them and keep them safe.

Staff protected people from harm and followed risk assessments to ensure they were supported in a safe way.

Staff had been recruited safely with appropriate pre-employment checks carried out.

Staff wore personal protective equipment (PPE), including face masks, when supporting people and were trained in infection control.

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.

People's care needs and any equality characteristics were assessed. Care plans recorded how people's needs could be met.

Management oversight of the service was not always effective in the absence of the registered manager.

The provider actively engaged with people and staff to be able to continuously learn and improve the service they provided.

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 13 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Good Neighbour Care on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation relating to management cover and leadership in the absence of the registered manager.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Good Neighbour Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service is registered with the CQC to provide a service to younger adults and older adults some of whom might be living with dementia, learning disabilities or autistic spectrum disorder, physical disability and mental health needs.

Not everyone using Good Neighbour Care 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 the inspection, 12 people were receiving the regulated activity.

There was a registered manager at the service. 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.

The last comprehensive inspection was in April 2017. The service was rated requires improvement in the key questions ‘Is the service Safe?’ and ‘Is the service Well-led?’. We found one breach of regulations in relation to not following safe recruitment procedures. The provider did not carry out appropriate recruitment checks to ensure people using services received care from staff who were safe and properly vetted and the registered manager did not provide us with all necessary staff information we requested.

Following the last inspection, the provider completed an action plan stating measures they would implement to address the breach of regulations by July 2017. At this inspection we found that recruitment systems had improved and robust recruitment checks were carried out as standard practice.

People and their relatives informed us that they were happy with the care and support that they received. People told us that they received consistent care from staff that they knew.

People were safe and staff were knowledgeable about reporting any incidents of harm. Staff received training in safeguarding people from abuse. Staff demonstrated that they understood the signs of abuse and how to report any concerns in line with the provider's procedures. People's needs were met by sufficient number of staff.

Risks related to people's lives and wellbeing were assessed, monitored and reviewed to support people's safety. Risk assessments were detailed and contained information to help staff fully understand and manage those risks.

People were supported with their medicines in a safe way. People's nutritional needs were met, and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received co-ordinated care and support.

People were treated with kindness, dignity and respect and they were supported to remain as independent as they wished.

People were involved and made decisions about all aspects of their care. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager and staff worked in line with the Mental Capacity Act 2005 to ensure they obtained people's consent before providing care and support.

People knew how to raise a concern or make a complaint and were confident that if they did, the registered manager would respond to them appropriately.

Staff received training to ensure they had the skills to care for people safely. They were supported in their role and received regular training and supervision to provide effective care.

There was an open and inclusive culture in the service. Staff told us they felt comfortable to approach the registered manager for advice and guidance.

Regular feedback was obtained from people using the service and their relatives. The registered manager monitored the service through a system of audits and used these to improve the quality and safety of the service.

Good Neighbour Care is a domiciliary care service run by Llayett Limited. At the time of inspection, the service was providing personal care to nine older people and people with dementia in their own homes.

The service had a registered manager 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 using the service and their relatives were very happy with the service and found staff caring, and helpful. People were happy with staff’s punctuality and found the service reliable and trustworthy, and were happy to recommend the service.

The service followed appropriate procedures to safeguard people from harm. Staff demonstrated good understanding of protecting people against abuse and their role in promptly reporting poor care. Risk assessments were individualised and provided sufficient information and instructions to staff on the safe management of identified risks. However, staff were not provided with detailed instructions on how to support people with medicines and risks involved if the medicines were missed. We found gaps in medicine administration records.

The service did not follow appropriate recruitment practices, some staff did not have updated criminal record checks and their references were not sought as per the provider’s policy.

Staff were well-trained and received regular supervision and support from the management to do their jobs effectively. Staff sought people’s consent before providing care and gave them choices. People’s nutrition and hydration needs were met. Staff maintained detailed daily care delivery records giving a clear account of how people were supported. The service worked with health and care professionals in improving people’s physical health.

Care plans were individualised and regularly reviewed, they recorded people’s needs, likes and dislikes. Staff were provided with instructions on how to support people to meet their needs and preferences. People were supported with social aspects of their life and with various activities when requested.

The registered manager regularly called people for their feedback but did not keep records of this. They visited people’s homes to observe staff whilst supporting people with their care needs to ensure they were supported as per their care plans. The service asked people and their relatives if they found care delivery effective via annual feedback survey forms. People and their relatives told us they were happy with the service, and found the registered manager approachable and helpful.

The service had systems and processes to assess, monitor and improve the quality and safety of the care delivery however, this did not always identify gaps in the record keeping.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to not following safe recruitment procedures.

You can see what action we told the provider to take at the back of the full version of the report.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in April 2015.

At the time of the inspection there were five people using the service. The service provides personal care, escort and cleaning services to older people.

The service had a registered manager. 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 using the service told us that they were very happy with the care and support that they received. Care staff knew the people they were supporting very well and carried out their duties with dignity and respect.

People receiving a service each had a detailed care plan which included specific details about how the person would like to be supported. A copy of the care plan was held at the persons own home. Care plans were reviewed and updated every six months or as and when required. Care plans included environmental risk assessments and risk assessments which took into account the premises and location of the property. However, the service did not identify and assess people’s individual associated risks and therefore did not provide staff with guidance on how to mitigate those risks to ensure people are kept safe at all times. This was highlighted to the registered manager during the inspection.

Care plans were signed by the people who received care and support as part of their initial assessment. However, the service was not obtaining peoples consent after a review of care and support had taken place so as to ensure people were involved with the review and agreed to any changes that had been made.

People told us that they felt safe and trusted the care staff that supported them. The service had a safeguarding policy and procedure in place which provided guidance on the actions to take if abuse was suspected. Staff could also explain how they would report abuse and their responsibilities around keeping people safe.

People told us that staff were always on time when arriving for their call. If staff were delayed for any reason, staff and the registered manager would always communicate effectively with them to keep them updated.

Staff recruitment processes were robust. Staff files showed that prior to their employment, all appropriate checks had been completed. This included a criminal records check, identity checks, two written references and confirmation that they were legally permitted to work in this country.

Training records that we looked at showed us that staff were provided with an in-depth induction programme, which covered a variety of topics. People that we spoke with also confirmed that they felt staff had the appropriate skills and knowledge to support them effectively.

The service had a supervision and appraisal policy in place. Staff told us that they were well supported by the registered manager. Staff told us that they met regularly with the registered manager and also received regular supervisions and spot checks. We saw evidence that these sessions had taken place. However, the service was not providing the number of supervisions, as required as per their company policy.

People told us that they did not have any complaints about the service. However, people said that if they had any issues or concerns to raise, they knew who to speak to and felt confident and able to do this. People also told us that were assured that their concern or issue would be dealt with immediately.

The service was in the process of devising an annual quality assurance procedure in order to obtain feedback from people who they provide care and support to. The registered manager told us that they regularly obtained feedback from people using the services with a view to learning and improving the service they provide. People we spoke with confirmed that the registered manager regularly asked their opinion on the service they received and if they were happy with the care and support that was provided.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach was in relation to assessing risks associated to people’s care and support needs. You can see what action we told the provider to take at the back of the full version of the report.