Stable Lives

Stable Lives is a domiciliary care agency providing personal care to older people in South Yorkshire, Sheffield. 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. At the time of the inspection 12 people were receiving support.

People’s experience of using this service and what we found

Quality assurance systems were in place, although these were not always effective. Audit systems and checks were not always identifying areas of development required. People were supported to share their feedback although there was no structured system in place to review feedback, consider suggestions or implement changes that people had highlighted.

There was a complaints policy in place and although people and relatives told us they knew how to make a complaint, processes were not always in place to evidence how complaints were managed. Documentation was not robust enough; records did not contain information about how complaints were responded to.

People received person-centred care, staff were familiar with the people they supported, and positive relationships had developed between Stable Lives staff and people receiving support. End of Life care was not being provided at the time of the inspection, the registered manager agreed that this was an area of responsive care that needed development.

Medication procedures were in place; people received a safe level of support from trained members of staff. Medication audits were regularly completed to assess compliance and staff performance. We identified some minor administrative errors that needed to be reviewed; the registered manager was responsive to our feedback.

People received personal care that was tailored around their individual support needs. People’s level of risk was assessed, and measures were put in place to ensure people received the safe level of care they needed.

Safeguarding and whistleblowing processes were in place. Staff received safeguarding training; they also explained the procedures they would follow if they had any safeguarding concerns.

Staffing levels were monitored and we received feedback to suggest that people received care and support from consistent and punctual members of staff. One relative told us, “They’re [staff] the best team of carers we’ve had.” Stable Lives staff were safely recruited; although we noted that systems needed to be strengthened so that records were more organised and contained all the relevant information.

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.

People and relatives told us that kind, caring and compassionate support was provided. One person said, “They’re [staff] like family.” People were treated with dignity and respect, were supported to remain as independent as possible and were involved in the care planning process.

We received positive feedback about the management and staff team at Stable Lives. People and relatives told us that they were committed to delivering high-quality, person-centred care.

Rating at last inspection and update

The last rating for this service was ‘good’ (published 2 August 2017). The service has deteriorated to ‘requires improvement’

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We identified a breach of regulation in relation to ‘good governance’. Please see the ‘action we have told the provider to take’ section towards the end of the report.

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.

Stable Lives provides personal care assistance for people who live in their own homes. The service supports people who may live with dementia, mental health conditions, physical disability and sensory impairment. The office is based in a commercial estate in Leeds.

Stable Lives was newly registered on 03 May 2016. Consequently, this was their first inspection.

During this inspection, people and their representatives told us they felt safe whilst being supported in their own home. A relative commented, “[My relative’s] safe in their hands, which we’re relieved about.” People said they had consistency of care staff and never had a missed appointment. We further noted recruitment and selection procedures the registered manager had ensured people were supported by suitably qualified and experienced staff.

The registered manager had systems to manage accidents and to maintain people’s safety and wellbeing. Care files we reviewed contained risk assessments to guide staff to protect people from unsafe support in their own homes. Additionally, staff demonstrated a good awareness of reporting procedures if they suspected abuse or poor practice.

We found staff managed people’s medicines, where applicable, with a safe and supportive approach. The provider ensured staff had up-to-date information, training and competency testing to underpin their skills and understanding of medication procedures.

The registered manager provided a range of training to underpin staff skills and knowledge. People who used the service and their relatives told us they found Stable Lives had effective, well-trained staff. Staff development was strengthened by regular supervision and appraisal.

Staff received training about the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. A staff member told us, “I really try to empower clients to make their own decisions in line with the Mental Capacity Act. It’s very much about respect.” People told us staff were respectful and supported them to make their day-to-day decisions.

We found staff and people who used the service worked together in the planning, review and provision of their care. When we discussed this with staff, they showed a good level of awareness regarding the importance of collaborative working. People and their relatives said they found staff were consistently kind and caring. A relative told us, “I think they are doing a fantastic job.”

We found care planning was aimed at helping people to maintain their independence. Care records were personalised to each person’s different requirements. Staff described good practice in their approach to people’s care in ways that maintained their dignity.

People who used Stable Lives said it was well organised and they felt able to contact them if they had any problems. On person said, “They are so flexible if we need an hour here or there. They are very accommodating.” We found the registered manager checked the quality of the service and experiences of those who accessed it. Records included evidence identified issues were quickly addressed.