Archived: Southwestern Care Services Ltd

On the day of our inspection the service was supporting approximately 70 people who lived in their own homes.

This report only covers our findings in relation to two of our key questions. Is the service safe and Is the service responsive. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for South Western Homecare on our website at www.cqc.org.uk.

The service requires a registered manager and at the time of the inspection 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.

The service was operating safe recruitment practices. All necessary checks including Disclosure and Barring Service checks (DBS) and reference reviews had been completed.

People’s complaints had been fully investigated and appropriate action taken to address and resolve any minor issues reported to the registered manager. One person who had recently made a complaint told us it had been investigated and resolved. Each month the service contacted everyone who the service supported to gather feedback about the care provided . The feedback was consistently positive and people told us, “I have never had anything to complain about they are very good” and “We have no problems, I would never change them. I raised something once and it was dealt with.”

People told us told us they felt safe and well cared for by their care staff. One relative said, “Oh yes [My relative] is safe. I feel they are looking after her” and “I could not and wished for anyone better to look after [My relative].”

There were sufficient numbers of staff available to provide all planned care visits and the service operated a call monitoring system to help ensure all planned care visits were provided each day. People and their relatives said, “I’ve had no missed visits” and “They have never had a missed visit, we have never been forgotten.” Daily care records and call monitoring information showed that people normally received care visits on time and for the correct duration.

In order to address the recommendation made as a result of our previous inspection findings the a new care planning format had been introduced. The updated care plans provided staff with sufficient detailed information and guidance to enable them to meet people’s needs. Staff told us, “The new ones they have done recently are really good” and “There is one in everyone’s house. They are quite good they have enough information in them.”

The provider operated a day centre as they had identified that many of the people they supported had become socially isolated as a result of their care needs. In addition, the service routinely provided support to enable people to live as independently as possible within their own homes. People told us staff had made them Christmas dinner and staff described how they had moved one person’s bed downstairs to enable the person to return home from hospital. People told us, “They go that little bit further to help” and a relative said, “When [My relative] is feeling tired she can ring them up and they will try to come earlier in the day to help her to bed.” Staff said, “The clients are what we are about” while the registered manager commented, “I do feel we go well above and beyond for the community” and “We do what we can to help people out. It’s what I do, it’s all I do.”

People consistently praised care staff for the kindness and compassion with which they provided support. People’s comments included, “They have been looking after me very well. I am well and truly happy with them”, “The staff are great, Superb. Nothing is too much trouble” and “They are my little darlings” and “They seem to enjoy their job.”

Southwestern Homecare is a domiciliary care agency that provides care and support to adults, of all ages, in their own homes. The service provides help to people with physical disabilities and dementia care needs in Helston and surrounding areas. . The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals. Longer visits for a ‘sitting’ service were provided for some people.

At the time of our inspection 57 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding.

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 who used the service, families and health and social care professionals told us they felt the service was safe. Comments included, “I have nothing but praise for them; nothing is too much trouble” and “The staff are caring and we trust the management to do the best for my [relative]. We are very happy with Southwestern Homecare.”

People told us staff always treated them respectfully and asked them how they wanted their care and support to be provided. People and their relatives spoke well of staff, commenting, “My lovely little darlings! I’m more than happy with them. Nothing is too much effort for them” and “They [staff] are really lovely, very kind. They know exactly what I need and I have a laugh and a joke with them” and “Staff are very polite and will go above and beyond to be helpful, like picking my prescriptions and my paper up for me.”

People told us they normally had a team of regular, reliable staff, and they knew the approximate times of their visits and were kept informed of any changes. Some people commented that agreeing a suitable time had initially been frustrating and they had shared this with the service. Wherever possible the service had worked to find suitable and agreed times for people. Some people had raised frustrations about not being kept informed of delays to their visits. This was picked up during quality assurance checks. Comments from people and their relatives included, “We had a few problems with timings at the start, it took a while to get into a settled routine but everything is fine now and we are pleased with them” and “They are all very competent and they seem to enjoy their work. They are a great gang.”

No one reported ever having had any missed visits. People told us, “We know the names of the staff coming to us and if there are any changes the office rings to let us know,” “We have four to five main carers who come to us” and “I have regular staff.”

Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. People told us they were involved in decisions about their care and their care plans, in which their needs and wishes were agreed.

Care plans did not always provide staff with direction and guidance about how to meet people’s individual needs and wishes. For example, we saw historical medical information on a care plan which did not indicate or support staff about how the person’s health was affected on an on-going daily basis.

Regular reviews of care plans took place but it was not always recorded clearly when reviews had happened. Changes in people’s needs were communicated to staff in daily records and during staff meetings. Risks in relation to people’s care and support were not always identified and appropriately managed. For example, there was no risk assessment in place for the use of unstable chair raisers which were in place when a hoist was required to help mobilise a person.

Staff were recruited safely, which meant checks had been made to ensure they were suitable to work with vulnerable people. New staff received an induction, which incorporated the care certificate. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. Staff received appropriate training and supervision. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

Staff and management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

There was a positive culture within the staff team and staff spoke positively about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The registered manager and office staff were also passionate about their roles and were clearly committed to providing a good service for people. Staff told us, “It’s a great company to work for; professional, supportive and flexible,”, “I love my job” and “They really care about the people we support and that sets the standard in everything we do.”

There were effective quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received. Comments from people included, “Excellent management and great support is always given. We appreciate everything they do for [relatives],”, “It’s an excellent service” and “We’ve had a few issues in the past around time factors, but they are very much improved.” People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to.