All inspections: Freedom Care Services - Care Quality Commission

This announced inspection was carried out between the 28 May and the 05 June 2015.

Freedom Care provides care in people’s own homes. At the time of the inspection there were 88 people using the service, most of whom had physical needs.

The service has 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.

During the last inspection carried out on the 25 June 2014 we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These were in relation to assessing and monitoring the quality of the service identifying and managing risk and how complaints were responded to. We found the improvements we required had now been made.

People were protected from avoidable risks and staff were aware of their duty of care to the people. Staff were trained to recognise and respond to signs of abuse. Risk assessments were carried out and reviewed regularly.

There were sufficient staff on duty to visit people in their own homes to ensure their care was delivered in a timely manner. Staff were well matched to the people they cared for.

People were assisted to take their medication safely when required.

The staff had appropriate training, supervision and support, and they understood their roles in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff assisted people to be in control of what they ate and prepared the meals they wanted.

Staff assisted people to contact their health care professionals. Staff ensured that where appropriate families were kept up to date on the health and welfare of their relative.

Staff were caring, kind and compassionate and cared for people in a manner that promoted their privacy and dignity. People felt listened to and had their views and choices respected.

People or their representative were involved in the decisions about their care and their care plans provided information on how to assist and support them in meeting their needs. The care plans were reviewed and updated regularly to reflect current needs and wishes.

The service had systems in place to assess, review and evaluate the quality of service provision.

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Freedom Care Services provides personal care to people in their own homes. Care and support is provided to older people, some of whom have dementia, and people with physical and other disabilities. As part of our inspection we spoke with people receiving care, the registered manager and staff working at the service and examined records relating to the service provided.

Below is a summary of what we found.

Is the service safe?

People we spoke with were generally happy with their care and support. One person receiving care told us, "The staff are good, especially the ones who know me well."

The provider was not fully ensuring risks to peoples' welfare and safety were identified and managed. Risks were not always identified promptly and appropriate action taken for the planning and delivering safe care.

Is the service effective?

People's needs were assessed and some information was provided for staff about their care needs. However, records did not contain information about any diagnosed health conditions or disabilities. Some risks that could affect people had not been adequately assessed and managed as part of the care planning process. This meant that care had not fully met people's individual needs.

Is the service caring?

People told us they were happy with the care they received. Care planning did not always take account of people's wishes, preferences and routines to ensure staff could provide personalised care that met their needs.

Is the service responsive?

Some systems were in place for obtaining people's views about the service provided but information was not collated and results produced. The provider did not have a complaints procedure that was given to people receiving care. We saw action was not always taken when needed in response to people's care needs. An example was where incidents of aggression had occurred and where people need help with their mobility.

Is the service well-led?

Some checks of care practice were completed by care coordinators. Systems were not adequate for analysing incidents that could cause harm. The registered manager did not have an effective system for identifying and managing risks or an overview of current concerns or areas of development at the service.

As part of our inspection we visited two people who used the service. We also spoke with other people who used the service and two relatives on the telephone to gain their views. We spoke with the registered manager, the operations director, the care co-ordinator, the agency manager and three care workers. We looked at service information and care plan files for eight people.

We found some concerns with the care planning process. Some people had not had their health care needs formally assessed or recorded and told us they had never had a care plan in their home. However other people found the service flexible to their needs.

The care workers we spoke with felt they were supported by the service to fulfill their roles and had received sufficient training. A person who used the service said of the care workers, 'The girls are wonderful, they are so caring.'

We found that care workers were being put at risk by not being allowed sufficient time to travel safely between the homes of people who used the service. This was because the provider did not have an effective system in place to identify, assess and manage the risks to the health, safety and welfare of people who used the service and staff members.

We saw that records were stored securely at the company office but were accessible to members of staff when needed.

During this inspection we checked to see if the provider had complied with actions we took following our last inspection in March 2012. We reviewed all the information we held about the provider including an action plan they had sent us detailing how they would become compliant.

During this inspection there were 67 people using the service. We spoke with five of these and with the relatives of two people who were unable to express their own views. We also spoke with four care staff; the office manager; and the registered manager.

People who used the service told us they were happy with the care and support they received. One person told us 'Staff are very caring.' Another said 'I am very pleased with the person that comes to me and with the support I get.' People told us they felt safe and knew how to raise any concerns they might have. All said that staff treated them with respect.

Staff we spoke with told us the provider was good in terms of ensuring that training was up-to-date and they enjoyed working there. One staff member told us, 'I really enjoy the work I do and feel confident that I do a good job.'

We spoke by telephone with one person who uses the service. They told us that they had been given a written care plan which covered, 'more or less', what they actually wanted from the service. They also confirmed that care staff follow their care plan and respect their privacy and dignity. Staff listened to, and acted on, what they said and were willing to change things if asked to. They said their regular workers were, 'brilliant.' However, they were concerned about changes in staff: they said they see a different staff member, on average, three times a month - adding, 'I need regular workers.'

The person we spoke with told us that they knew how to make a complaint if they were not happy with the service.

Archived: Freedom Care Services

All Inspections

28 May - 05 June 2015

During a routine inspection

25 June 2014

During a routine inspection

23 October 2013

During a routine inspection

14 January 2013

During an inspection looking at part of the service

21 March 2012

During an inspection in response to concerns