Applewood Support Limited

Applewood Support Limited is registered to provide personal care to people who live in their own homes. At the time of the inspection 60 people were supported by the agency. This included older people, some of whom were living with dementia and, or, specific health conditions.

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

Since our last inspection, improvements had been made to personalise care records, so staff had information about what people liked to talk about, their hobbies and interests. People and their relatives gave us positive feedback about staff being kind and caring toward them. Staff promoted people’s independence and maintained people’s privacy and dignity.

Overall, staff knew people well and how to reduce risks of harm or injury. However, risk management plans had not always been written when risks had been identified. This meant new staff or staff covering care visits did not always have important information to refer to if needed and regular staff could not refresh their knowledge of people's needs.

Staff had received training on how to protect people from the risks of abuse and understood the importance of reporting any concerns.

Staff understood how to reduce the risks of spreading infection. People had their prescribed medicines available to them and were supported with these from trained care staff.

There were sufficient staff and people received their care visits at the agreed times. The provider had a call monitoring system that created an alert if care staff were running late. When alerts were received these were acted on to ensure people received their care visit. The provider had a safe recruitment system to ensure staff’s suitability to work at the home.

People’s needs were assessed before their care visits commenced. People were supported with their food and drink where this was part of their agreed care. Staff worked within the principles of the Mental Capacity Act 2005 and understood the importance of gaining consent from people.

There were systems were in place for people and their relatives to give their feedback on the service. People felt well cared for and they, and their relatives had no complaints.

There were some quality assurance systems in place to check the safety and quality of the services. However, improvement was required to the managerial oversight through audits to ensure these were robust and identified any issues where improvements were needed.

The provider and registered manager needed to refresh their knowledge about when they were required to send statutory notifications to CQC and ensure they met their legal responsibilities.

Rating at the last inspection

The last rating for this service was Good (published 26 May 2017).

Why we inspected

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service had a registered manager. 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.

Quality assurance systems were in place to review how people received the care and to ensure quality. However, people generally received the support visit on time but some people did not receive their support for the agreed length of time. There were processes to monitor the quality of the service provided although these systems had not identified concerns receiving the correct length of support time.

People were treated with care and kindness and they were supported to be as independent as possible. People received support that was individualised to their personal preferences and needs. Positive and caring relationships had been developed between staff and people who used the service. Where risks had been identified, measures were taken to reduce or prevent potential risks. People felt safe and staff were trained in safeguarding adults and understood how to protect them from abuse.

Staff sought people’s consent before they provided care and support and they were involved in the planning and reviewing of their care. People were treated with dignity and respect by staff who understood the importance of this. Staff gained information about what was important so that they could provide care which met their preferences. People had support to take their medicines at the right time and staff knew how to act if medicines were missed. Where assistance was required, people received support to prepare and eat their meals and had access to food and drink between support visits.

People had capacity to make decisions about their own care and their consent was sought before staff provided any care and support. The provider was flexible and responsive to changes for support times. New staff had been recruited and checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service. Due to the recruitment of new staff, there were sufficient numbers of staff to ensure visits were made when they should be and to meet people’s care needs.

People received kind and compassionate care and were supported to maintain their dignity, independence and privacy. Staff had access to training to improve their knowledge of care and enhance their skills. People benefitted from receiving a service from staff who worked in an open and friendly culture and were happy in their work and supported by senior staff.

People knew how to make a complaint if they needed to. People and staff were confident they could raise any concerns or issues with staff in the office and the registered manager, knowing they would be listened to and acted on.