We inspected Firstcol Services Limited - Domiciliary Care on the 17 November 2015 and it was an announced inspection. Forty eight hours’ notice of the inspection was given to ensure that the people we needed to speak to were available. Firstcol Services Limited – Domiciliary Care is a domiciliary care agency providing personal care to a range of people living in their own homes. These included people living with dementia, older people, people with a physical disability, people with a learning disability, young children and people receiving end of life care. At the time of our inspection, the service was supporting up to 72 people and employed 20 members of staff.
A manager was in post but not yet registered with the Care Quality Commission. They had submitted their application and were awaiting their registered manager’s interview. 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, relatives and care workers spoke highly of the service. One person told us, “The service we get is excellent.” A relative told us, “We are very happy with the service we get. The office is very helpful and they will ring if the carers are going to be late because they have been held up with the previous call.”
People received safe care, however documentation such as risk assessments were not consistently robust. Risks to people’s safety were undertaken and risk assessments in place. However, risk assessments lacked sufficient guidance and information for care workers to provide safe care. Moving and handling risk assessments failed to include guidance on the sling size, whether the person could participate in the transfer and what may prevent a safe transfer. Medicine risk assessments were generic and not personalised to the individual. We have identified this as an area of practice that needs improvement.
Where restrictive practice was taking place, the provider was unable to demonstrate if the restriction was in line with legal requirements. Care workers provided care and support to young children and also attended households where children were present but had not received child protection training. We have identified this as an area of practice that needs improvement.
The ethos, values and visions of Firstcol Service Limited – Domiciliary Care was embedded into everyday care practice. The provider, manager and management team were committed to providing high quality care. A robust quality assurance system was in place and the provider encouraged people and care workers to feedback about how the service was run. The provider demonstrated a commitment to quality and was passionate about influencing the delivery of home care in the local area.
People were assured that care workers had been appropriately recruited as their employment procedures protected people by employing care workers that were suited to the job. There were sufficient numbers of care workers that had the skills they needed to provide people with safe care and support.
People confirmed care workers respected their privacy and dignity. One person told us, “The care I get is excellent. The staff are really caring and always think of me first. They treat me with real respect, not just doing it, it’s genuine.” Another person told us, “The care I get is excellent. They know exactly how to care for me and how to do it. They certainly treat me with respect which is nice.”
Staff had a firm understanding of respecting people within their own home and providing them with choice and control. The service had identified people’s needs and preferences in order to plan and deliver their care. People said the service met their needs and encouraged them to be as independent as possible. People were asked for their views of the service and said they knew how to make a complaint about the service if they needed to.