The Care Company Plus Limited

The Care Company Plus is a domiciliary care agency providing personal care for people living in their own homes. The service was supporting 80 people at the time of our 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

Feedback from people and their relatives was positive about the support provided. People received the support they wanted and were complimentary about the caring staff team.

The management team reviewed records each month. We have made a recommendation to ensure records are returned to the office in a timely manner for checks to be made and to ensure information is kept up to date.

People and relatives said the management team were approachable. Most staff were also positive about working for The Care Company Plus and felt well supported by the management team. The manager sought feedback from people, their relatives and staff through reviews, surveys, staff meetings and supervision meetings.

Staff received the training they needed for their role, although this hadn’t all been recorded on the company’s training matrix. Staff were safely recruitment; however, their full employment history was not always recorded. The manager said they would ask about any gaps in employment history during the interview process.

Clear care plans, risk assessments and task sheets identified the support people needed. These were regularly reviewed to ensure they reflected people’s needs. Where identified in their care plan people received support with their medicines, food, health needs and to observe their faith.

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.

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 6 October 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 Care Company Plus Limited (The Care Company Plus) is a domiciliary care agency which provides personal care and support to people living in their own home. Their office is located in North Manchester and the agency provides care and support to people living in Bury, Manchester and Trafford. At the time of our inspection the service was supporting 96 people.

The service had a registered manager who had been in post since July 2016. 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 and their relatives told us they received care and support that was safe.

There were robust recruitment processes in place. This helped to ensure suitable staff were employed.

Risk assessments were in place and contained sufficient details and guidance to help ensure people were supported safely.

There were suitable systems to help ensure people were protected from harm. Staff were well-informed about the types of abuse and the action they would take if they suspected that abuse was taking place. This meant people using the service were protected from harm due to organisation systems and staff knowledge.

People and relatives told us they had consistent staff supporting them. This meant people were supported by people who knew and understood their needs. People told us staff arrived punctually for their visits and they were informed if staff were running late. This meant that people received care and support at times that suited them.

People told us staff had good hygiene practices and wore personal protective equipment when carrying out their duties. This should help to ensure that people were protected from the risk of infection.

Where required, people were supported to take their medicines safely. We noted the registered manager had taken further action to ensure medication administered was recorded appropriately. We were assured that there were effective systems in place to help ensure people were supported safely with their medicines.

People and their relatives told us staff were well trained and did their jobs effectively. Staff received an induction and mandatory training prior to working with people. There was evidence that staff were supported with on-going and refresher training as required. Staff received regular supervisions and appraisals to help ensure they received the necessary support to carry out their roles. Staff we spoke with confirmed this. This meant staff had the right knowledge and skills and received continuous support to function effectively in their caring role.

Staff sought people’s consent before undertaking tasks. Care records we looked at contained evidence that people had consented to the care they received. We saw improvements had been made to ensure the service worked within the principles of the Mental Capacity Act (MCA). This meant people’s rights were protected.

Where needed, people were supported with meal and drink preparation. Everyone we spoke with told us they were satisfied with the support provided and said the staff always consulted them prior to carrying out the task. This helped to ensure people maintained good nutrition and hydration.

People told us the service supported their access to health care professionals and medical attention, if required. In the case of an emergency, medical attention was sought and relatives contacted. This meant people were supported in a proactive way to receive the right health care when they needed.

People and relatives told us staff were kind and compassionate and that they considered them to be part of their family. People told us they were treated with dignity and respect and that staff carried out their duties in a professional and calm manner.

People gave us examples of how staff encouraged them to be independent according to their abilities. Staff we spoke with confirmed this. This helped to promote people’s general good health and wellbeing.

People and relatives told us care and support was responsive to their needs and gave us examples of how the service provided person-centred care.

Initial assessments were carried out to help ensure people could be supported. Care plans contained detailed and person-centred information about the care and support people required and were regularly reviewed. This meant staff had up to date and relevant information about people’s needs to be able to support them responsively.

People and relatives told us they were aware of how to raise a complaint though no one we spoke with had raised any complaints. We saw complaints received had been managed appropriately. We concluded the service had adequate systems in place to manage complaints effectively.

We saw people and relatives had the opportunity to provide feedback about the service provided. We noted the service had sent out user satisfaction survey in January 2017 and had done a telephone survey in April 2017. The results of both surveys were positive and we noted the registered manager had developed an action plan to progress the improvements identified from these surveys.

People and relatives told us the service was well managed and said they had a good relationship with the office staff. They said they were approachable and helpful.

Quality assurance systems adequately identified areas for improvement within the service and the registered manager was able to demonstrate what actions were taken to ensure the quality of the service was maintained.

There were policies and procedures in place; this should help to ensure staff had appropriate guidance to carry out their roles.

Quarterly staff meetings were held which gave staff the opportunity to discuss their work with managers and colleagues.

The registered manager and the director attended various forums within the care sector. This involvement helped them to share best practice and also keep up to date with issues affecting the sector.

The previous inspection took place in May 2014. At this inspection, we found that the service had met all regulatory requirements.

The service had been without a registered manager for just over one year. A manager had been recruited in January 2016 and we saw that they had submitted their application to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 breaches of regulations. You can see what action we have told the provider to take at the end of the full report.

People told us they felt safe using the service. This was in part due to the consistency of the care staff that visited them, and staff’s knowledge and competence. We found the company’s recruitment processes were robust, ensuring that all appropriate checks were done before staff started working with people.

We saw identified risks and actions to be taken to reduce these risks were recorded in people’s care plans. Risk assessments were done, for example, for manual handling, eating and drinking, and medication administration. We saw some good examples of clear and specific guidance to help staff manage risks to people. However there were some assessments that were not always so clear. We highlighted these gaps to the manager.

Staff were trained in safeguarding vulnerable people and knew what action to take if they suspected abuse was happening. We saw that safeguarding was a regular agenda item at peer group or team meetings and there was an up-to-date safeguarding policy to guide staff.

People told us they were supported appropriately with taking their medicines and we saw that medicines administered were recorded by care staff.

People we spoke with said that their care staff did not keep them waiting and that they had had no missed visits. The service told us they used an electronic call monitoring system which helped to ensure that missed calls were kept to a minimum.

We did not see evidence that the service fully understood and put into practice the principles of the Mental Health Act 2005. In some people’s care plans we saw that relatives had signed them on their behalf. However, we did not see any records to show that relatives had permission to sign on people’s behalf. People were potentially receiving care or support where consent had not been obtained in the appropriate way.

The service had formal systems in place to train and support staff. We saw that staff received quarterly supervisions and annual appraisals, where appropriate. The service was delivering the Skills for Care, Care Certificate as part of its induction programme. Management and staff told us the training programme was good and that group work and discussions had been introduced to complement DVD-led instruction. We noted however that some care staff were overdue for training updates in key areas of their knowledge.

People were happy with the quality of care and support they received from The Care Company Plus. They thought of care staff as either friends or family. People appreciated that they had regular carers because this encouraged relationship building and trust. People told us they were supported to maintain their independence according to their abilities and care staff were able to give us examples of how they did this.

People and their relatives said they were involved in planning their care and support. This should help to make sure that people’s needs were met effectively. People’s cultural and religious diversity and how this affected the care and support provided was also a key feature noted within their care plan. But care plans were not consistently person-centred. We noted that plans contained no personal histories nor did they describe people’s likes or dislikes.

The service actively sought out people’s views on how the service was being delivered. This should help the service with making improvements to maintain quality. There was an up-to-date complaints policy and procedure in place and we saw that people had received a copy of this. People we spoke with knew how to make a complaint or raise a concern but many did not have cause to do so. We saw that the service addressed concerns and complaints in a prompt and professional manner.

The service had quality assurance systems in place to monitor, for example, staff performance, care plans and medication administration. We did not see any analysis done of concerns and complaints raised and feedback from user surveys. Quality assurance could potentially be enhanced and driven by such analysis.

There was a manager in place and they were currently in the process of registering with the Care Quality Commission.

We saw that the provider had a suite of policies and procedures to help guide staff in their caring role. Staff attended quarterly peer group or team meetings at which good practice and the company’s policies and procedures were discussed.

People were happy with the Care Company Plus. They told us they found the staff and management helpful and friendly, and always available when needed.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

During the inspection we spoke with four people who used the service, two relative's, five care staff, and three members of the office management team. The registered manager was not present during the inspection, therefore we also spoke with two directors of the service. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

Is the service safe?

We saw that people were treated with respect and dignity by the staff. We spoke with four people who used the service who all told us that staff respected their privacy and dignity and supported them in a way that suited their individual needs and personal preferences. We also spoke with two relative's who told us they were happy with the care and support the staff provided to their family members. We saw that the service had systems in place to identify and respond to allegations of abuse and we checked that staff were knowledgeable of these and the actions to take if they had concerns for a person's safety. Systems were in place to make sure that the service sought people's feedback and that risks were identified and managed.

Is the service effective?

We saw that people who received care and support from Manchester Asian Care had a care record that included assessments of their individual needs and risks. The care plan had been developed to meet those assessed needs. The assessments and care plans were reviewed on a six monthly basis and updated accordingly. We saw that one care record required updating. This was discussed during the inspection and we saw that this was currently being completed. Prior to people receiving care and support, we saw that information regarding the person's health needs was obtained from other health professionals, such as social workers and a member of staff visited the person to carry out an assessment of their needs. This meant that people could feel confident that the service could meet their individual and personal care needs. We were told that relatives were encouraged to be involved in the person's care and treatment, if their family member consented to this.

Is the service caring?

All the people we spoke with were complimentary of the staff and management of Manchester Asian Care. We were told that the service engaged with them to ensure that their needs and wishes were met. Some comments included; 'My needs have changed so the care's had to change and they were simply brilliant', 'They're very good, they can't do enough for (my family member)' and 'Faultless.'

Staff spoken with were all positive regarding the care that was delivered. Some comments included: 'I feel comfortable with all the office staff, they're open and approachable, they're brilliant,' and 'We want to improve people's lives.' We spoke with two relatives who confirmed they were happy with the care and support provided. One person said '(My family member) has a fantastic relationship with the staff. They are really caring and professional.'

Is the service responsive?

The service had systems in place to ensure that people were regularly consulted about their views and ideas on how the service should be run. This was done by means of regular discussion with people and satisfaction surveys. We saw that if improvements were identified, these were actioned as appropriate and staff were informed of any changes required. All the people we spoke with told us that they were happy with the service provided and were involved in making decisions about their care and support. Comments we received included; 'They don't make assumptions, they work with you'; 'We did my care plan together'; 'They met with me and went through everything. I could see I was important to them' and 'It's very good.' This showed us that people were consulted in the development of a care plan which met their needs.

Is the service well led?

For the areas we looked at during this inspection visit we saw that staff had received appropriate training to ensure they had the knowledge, skills and experience to meet the assessed needs of people receiving care and support. This meant that people who received support from Manchester Asian Care could be confident that their needs were being met by fully trained staff. When we spoke with staff they spoke highly of the support they received from the manager and the senior staff. They told us they received regular supervision and training. They also told us they had regular staff meetings and if they had any problem they would go straight to the manager who was always available and approachable.

We found that people were involved in their care and were asked before care was provided. We found that the care people received was of a good standard. The provider had proper arrangements in place to ensure people received their medication where appropriate and there were sufficient staff on duty to meet people's needs.

Since our last inspection, we found that the provider had improved its' systems for managing people's individual risks properly. The provider responded appropriately to complaints and comments.