Archived: Care Connect Homecare Services

Care Connect Homecare Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection there were 85 people using the service, 75 of them were receiving personal care.

Not everyone who used the service received personal care. The Care Quality Commission (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

People told us they felt safe and were happy with the service they received. They said staff were kind, caring and friendly. Safeguarding adults’ procedures were in place and staff understood how to protect people from abuse. Recruitment processes ensured new staff were suitable to work for the agency. There were enough numbers of staff deployed to meet people's needs in a punctual, consistent and flexible way and to ensure their safety. People received their medicines when they needed them from staff who had been trained and had their competency checked. We found the management of ‘as needed’ and external medicines was not consistent, however, the provider recognised the shortfalls and additional improvements were being made in relation to the process and to the auditing tool. Risk assessments were carried out to enable people to retain their independence and receive support with minimum risk to themselves or others. Accidents and incidents were monitored and infection control processes were managed well.

People were given 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. People’s care and support needs were assessed prior to them using the service to ensure their needs could be met. Staff received ongoing training, supervision and support. People were supported at mealtimes in line with their support plan and staff worked in partnership with healthcare professionals, when needed.

Management and staff had developed friendly, caring and respectful relationships with people using the service and their families. People’s care was tailored to their needs and staff knew about their routines and preferences. People, or their family members, had been consulted about their care needs and had been involved in the care planning process. People had access to activities if this was in line with their care plan. People knew how to raise any complaints, concerns and compliments.

Improvements were being made to the way the quality of the service was monitored in areas such as medicines management and record keeping. When any shortfalls were noted, appropriate action had been taken. Staff received support from management team and they felt valued. People’s views and opinions of the service were sought and acted on.

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 8 September 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 was last inspected in June 2016. At that inspection we found two breaches in the Health and Social Care Act 2008 Regulated Activities Regulations 2014 in relation to the management of people’s prescribed medicines and recruitment procedures. This resulted in us making two requirement actions. The provider sent is an action plan telling us what action they were to take to make the necessary improvements. During this inspection we checked to see what action had been taken. We found that improvements had been made and the requirement actions had been met.

Care Connect Homecare Services is a domiciliary care agency providing personal care and support to people living in their own homes across Bury and Radcliffe. At the time of our inspection the service was supporting approximately 130 people.

The service has a registered manager. However they have been absent from work since October 2015. Alternative management arrangements were in place to support the day to day running of 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.

Systems were in place to support people with their prescribed medicines. During this inspection we have made a recommendation about the management of some medicines.

People and their relatives told us they were happy with the care received and that staff supported them in a dignified and respectful manner. Staff spoken with demonstrated a clear understanding of their responsibilities and gave examples of how people’s privacy and dignity was promoted and maintained.

Robust recruitment procedures were in place ensuring only those applicants suitable to work with vulnerable people were appointed. More effective arrangements were being put in place to help ensure people were supported by sufficient numbers of staff in a consistent and planned way.

People told us they felt safe with the staff that supported them. Staff had completed training in how to safeguard people from abuse and knew the action they should take if they had any concerns. Suitable arrangements were in place where the agency had access to people’s house keys and finances. These systems helped protect people who used the service.

The service worked closely with other professionals so that people's physical and health care needs were effectively met. Areas of potential risk had been identified, assessed and planned for to help reduce or eliminate the risks to people.

People told us they were actively involved and consulted with in planning their support package. Staff were aware of the importance of seeking people’s permission before carrying out tasks.

Opportunities for staff training and development were provided enabling staff to develop their knowledge and skills. This helped to ensure people were supported safely and effectively so their individual needs were met.

Suitable arrangements were in place to help ensure people’s nutritional needs were met.

People's care records provided sufficient information about their wishes and preferences and guided staff in the support people wanted and needed.

The provider had a system in place for the reporting and responding to any complaints brought to their attention. People and their visitors told us the office and care staff were approachable and were confident they would listen and respond to concerns raised.

We saw effective systems to monitor, review and assess the quality of service were in place so that people were protected from the risks of unsafe or inappropriate care. Opportunities were provided for people, their relatives and staff to comment on their experiences and the quality of service provided.

The provider reported any accidents, serious incidents and safeguarding allegations which should be notified to CQC. This information helps us check the service is taking action to ensure people are kept safe.

Pre-inspection information requested from the provider, which is required by law, had been provided to CQC as requested.

The CQC rating and report from the last inspection was displayed at the agency office as well as on the provider web site.

Care Connect Homecare Services is a domiciliary care agency which at the time of our inspection was providing personal care to 128 people who lived in their own homes.

Although the service had a registered manager in place as required under the conditions of their registration with the Care Quality Commission, this person had been absent from work since October 2015. The registered manager was also one of the two business partners who were the registered providers of 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. In the absence of the registered manager their business partner had taken over the running of the service since November 2015.

During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because the recruitment processes in place were not sufficiently robust. In addition systems needed to be improved in order to ensure the safe handling of medicines. You can see what action we have told the provider to take at the back of the full version of the report.

Appropriate action had not always been taken to ensure people who used the service were protected from the risk of unsuitable staff. This was because risk assessments were not always completed in a robust and timely manner when criminal record checks showed that people who had applied to work in the service had previous convictions. This meant people who used the service might not be protected from potential risks.

Although people who used the service told us they always received their medicines as prescribed, we noted medication administration record (MAR) charts were not always full completed to confirm this was the case. Medication audits had not been completed since January 2016. In addition we could not find evidence on some of the staff files we reviewed that assessments had been undertaken to check that staff were able to safely administer medicines.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe. They told us they were certain any concerns they raised would be taken seriously by the managers in the service.

People who used the service told us staff did not always arrive on time although they did not consider this had a negative impact on the care they received. They told us staff were always happy to carry out any tasks requested of them.

Staff told us they received the training and supervision they required to be able to effectively carry out their role. However we found the systems for accurately recording the supervision and training staff had received needed to be improved.

Although records showed only 50% of staff had received training in the Mental Capacity Act (MCA) 2005, all the staff we spoke with demonstrated their understanding of the principles of this legislation. Staff told us how they always respected the rights of people to make their own decisions and to have their preferences respected in relation to the care they received.

Risk assessments for physical health needs and environmental risks helped protect the health and welfare of people who used the service. Arrangements were in place to help ensure the prevention and control of infection.

Where necessary people who used the service received support from staff to ensure their nutritional needs were met. We were told that staff would contact health care professionals such as a person’s GP if they had any concerns regarding the person’s medical condition.

All the people we spoke with gave positive feedback regarding the kind and caring nature of staff. People who used the service told us they were able to make choices about the care they received and staff enabled them to maintain their independence as much as possible. Staff we spoke with demonstrated a commitment to providing high quality, person centred care.

We saw that people were involved in reviewing the care they received; these reviews were used by senior staff to check that people were happy with their care. We saw that, if they considered a person’s needs had changed, managers in the service would request the local authority conduct a review of the commissioned care package to ensure the care people received was appropriate to their level of need.

We noted that there was a complaints procedure in place for people to use if they wanted to raise any concerns about the care and support they received. All the people we spoke with told us they considered their views would be listened to and any complaints taken seriously. None of the people we spoke with during the inspection had any complaints about the service.

There were a number of quality assurance systems in place to help drive forward improvements in the service. Staff told us they enjoyed working in the service and considered they provided a high quality of care. They told us the level of organisation in the service had improved since the provider had taken over the running of the care agency.