We carried out a review of the data available to us about Care2Care (Yorkshire) Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Care2Care (Yorkshire) Ltd, you can give feedback on this service.
Care2Care (Yorkshire) Ltd is a domiciliary care service providing care and support to people in their own homes. The service was providing personal care to 24 people at the time of the inspection.
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
The service had responded positively to issues identified in the last inspection that might affect people’s safety. Medicines were now managed safely and care records, including risk assessments, included the detail needed to make sure people’s needs were met safely.
Staff were recruited safely and followed an induction and training programme which had been developed and improved since the last inspection to make sure staff received the training they needed. People felt staff were well trained, but some felt new staff would benefit from a longer period of shadowing more experienced staff.
People we spoke with were complimentary of the care and support they or their relative received and commented positively about the respect staff showed to make sure dignity needs were maintained.
People or, where appropriate, family members said they were fully involved in the development and review of care plans to make sure care and support was delivered as needed and preferred. One person summed this up saying, “I will talk to them about how I want my care provided and the carers are open to that and will respect what I have said to them.”
Care plans were person-centred and included information about what staff needed to do to make sure people’s individual needs were met. Care plans in relation to people’s communication needs would benefit from some further development.
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.
Staff were responsive to people’s health needs and liaised with healthcare professionals as needed.
The service had improved their management of complaints and people told us any issues they encountered were dealt with efficiently and appropriately.
Systems to effectively monitor the quality and safety of the service had been introduced to equip the provider with a robust overview of performance.
People, their family members and staff gave positive feedback about the registered manager. Plans were in place to develop the inclusive culture within the service to further promote quality of care.
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 requires improvement (Published 18 January 2019) and there were breaches of regulations 12,17 and 18. At this inspection sufficient improvement had been made, and the provider was no longer in breach of these regulations.
Why we inspected
This was a planned inspection based on the previous rating.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people, adults, young people, people with learning and profound disabilities and people at the end of life. Not everyone using Care2Care (Yorkshire) Ltd 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 29 people were receiving personal care from the service.
At the last inspection in August 2017, the service was rated requires improvement. There were breaches in Regulation 17 good governance and Regulation 19 fit and proper persons employed. At this inspection we found some improvements, however, the service was still in breach of Regulation 17.
There was a registered manager in post. 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 told us they felt safe. Staff knew how to recognise and report any concerns about people's safety and welfare. Risks to people’s health and safety were not always assessed to help protect people from harm.
We found medicines were not always managed in a safe or proper way. We found discrepancies with medicine administration records (MARs).
There were enough staff deployed to ensure people received care. Safe recruitment procedures were followed to help ensure staff were of suitable character to work with vulnerable people.
Staff did not always receive appropriate training. However, they told us the training they had received was good and relevant to their role. Staff were supported by the manager and were receiving formal supervision where they could discuss their ongoing development needs.
People who used the service and their relatives told us staff were helpful, attentive and caring. We saw people were treated with respect and compassion.
Care records did not always contain sufficient detail for staff to know what support to offer people. People felt they participated in planning their care. Care records included information about people’s preferences, likes and dislikes.
The service worked in partnership with other agencies including health professionals to help ensure people’s healthcare needs were met.
Staff knew about people’s dietary needs and preferences. People told us their choice of meals was followed.
A complaints procedure was in place, which enabled people to raise any concerns or complaints about the care, or support they received. However, the service did not always record complaints in a consistent way.
People using the service, relatives and staff we spoke with were positive about the management team. Staff said the registered manager was approachable and supportive.
We found the provider’s quality monitoring systems were not always working as well as they should be. Some of the concerns we found at our inspection should have been identified through a robust system of checks.
We found three breaches of regulations in relation to safe care and treatment, good governance and staffing training. We are considering the appropriate regulatory response to our findings.
We inspected Care2Care (Yorkshire) Limited on the 8, 23 and 25 August 2017. We announced the first day of inspection 48 hours prior to our arrival to make sure the registered manager would be available. This was the first inspection of the service since registration in February 2016.
There was a registered manager in post. 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.
We found staff received training to protect people from harm and they were knowledgeable about reporting any suspected abuse. Including the registered manager and other senior staff members there were sufficient number of staff employed for operational purposes. However, the registered manager confirmed additional staff were required to meet demand and before the service could take on new contracts.
There was a staff recruitment and selection procedure in place designed to ensure only people suitable to work in the caring profession were employed. However, we found this was not always being followed correctly.
Where risks to people’s health, safety and welfare had been identified appropriate risk assessments were in place, which showed the action taken to mitigate those risks.
The people we spoke with and their relatives told us the service was generally reliable and staff usually arrived around the same time each day and stayed for the correct amount of time.
The staff we spoke with were able to describe how individual people preferred their care and support to be delivered and the importance of treating people with respect in their own homes.
Staff told us the agency provided good training opportunities. However, we found the training matrix was not up to date therefore the agency was not able to evidence the training being provided.
The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff demonstrated good knowledge of the people they supported and their capacity to make decisions.
The support plans we looked at were person centred and were reviewed on a regular basis to make sure they provided accurate and up to date information. The staff we spoke with told us they used the support plans as working documents and they provided sufficient information to enable them to carry out their role.
If people required staff to assist or support them to prepare food and drink information was present within their support plan and staff told us they encouraged people to eat a healthy diet.
Staff ensured people had access to a GP and other healthcare professionals when they needed medical attention and people told us they had contact details for the agency which they could use out of normal office hours in case of emergency.
Procedures were in place to ensure people received their medicines as prescribed. However, we found staff were not always completing the medication administration records [MAR] correctly and this had not been identified through the internal audit system.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. People told us they felt able to raise any concerns with the registered manager and felt these would be listened to and responded to effectively and in a timely manner. However, we found not all formal complaints were being recorded in the complaints register as required.
There was a quality assurance monitoring systems in place that was designed to continually monitor and identify shortfalls in service provision. However, we found the systems in place were not sufficiently robust and had not identified the shortfalls in the service we found during the inspection.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.