Continuity of Care Services Limited

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. A relative told us, “I’m finding the carers rewarding for my relative. They do a really first-class job. They’re head and shoulders above other care companies. It’s changed our life”.

‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: The model of care maximised people’s choice, control and independence. A relatives told us, “The carers promote my loved one’s independence” and “I think I’ve had enough involvement in the care plan”. People were supported to achieve their goals and agreed how to manage any risks with staff.

People were supported by a small number of staff they knew well and trusted. A relative said, “There is a team of the same carers, familiarity is important”. A person told us, “I have a very good relationship with the management. They were the first to come out and introduce me to the company. They also did my care for the first two weeks to get firsthand experience of my care needs”. Staff supported people to take their medicines safely. People were involved in recruiting staff who were of good character and had the skills to meet their needs.

Right Care: Care was person-centred and promoted people’s dignity, privacy and human rights. People told us they felt safe with staff. Staff knew how to identify risks of abuse and were confident to raise any concerns. Infection control risks were managed.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people lead confident, inclusive and empowered lives. Checks the provider completed had improved the quality of the service. Staff felt supported by the provider who was approachable. Everyone we spoke with told us they would recommend Continuity of Care Services.

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 21 October 2017.

Why we inspected

This was a planned inspection based on the date of the last inspection.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Continuity of Care Services Limited is registered as a community based domiciliary care agency (DCA) which delivers personal care to people living in their own homes or to children living with parents. At the time of our inspection the agency was supporting 12 people, with the regulated activity of personal care. The agency offered people additional services such as, domestic calls, shopping and companionship. This was the first comprehensive inspection since the agency was registered.

At the time of our inspection, there was a registered manager in place who was also the owner of the agency and the registered provider. 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.

Relatives and staff spoke highly of the registered manager who was committed to providing a high quality service to people. The registered manager had developed links with the local community to raise the profile of health and social care, and the benefits of working within the industry. Systems were in place to monitor the quality of the service being provided to people through regular checks and audits. People’s and significant others views were not actively sought and acted on to improve the service that was provided to people. We have made a recommendation about this.

People received a service that was safe and relatives told us they felt their loved one was safe. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. The safety of staff who were working in the community had been assessed with systems put into place to reduce the risk to staff. Risks to people’s safety had been assessed and recorded with measures put into place to manage any hazards identified.

There was enough staff with the right skills and knowledge to meet people’s needs. Staff received the appropriate training to fulfil their role and provide the appropriate support, including specialist training to meet some people’s complex needs. Staff were supported by the registered manager who they were in contact with on a regular basis. A comprehensive induction programme was in place which all new staff completed, this included the Care Certificate, and this is a nationally recognised qualification. Staff had a clear understanding of their roles and people’s needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and/or their relatives and reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff within people’s homes about how to provide all areas of the care required. People’s care plans were individualised and person centred.

People were treated with dignity and respect whilst receiving care and support from the agency. People were supported to make their own decisions and remain as independent as possible. Staff supported people in the least restrictive way possible. Staff understood the principles of the Mental Capacity Act 2005. Information about people’s likes, dislikes and personal histories were recorded within their care plan.

People were supported to remain as healthy as possible. Guidance was available within people’s support plans to inform the staff of any specific health condition and support needed. Staff monitored changes in people’s health and sought appropriate help from medical professionals when required. People were encouraged to maintain as much independence as possible. People’s nutrition and hydration had been considered and recorded, with guidance in place for staff to follow from health care professionals.

Where staff were involved in assisting people to manage their medicines, they did so safely. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

Systems were in place to monitor and respond to concerns or complaints that had been raised. Complaints were seen as a positive way to improve the service which was being provided to people. A complaints policy and procedure was in place and information about how to make a complaint was provided to people and/or their relatives within the service user guide.