Archived: Exclusive Therapies Limited

Updated 6 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 and 21 July 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service providing support to people in their own homes. We needed to be sure that someone would be available at the office. Calls to people who used the service and staff were made on 25 July 2017 to gain their views.

The inspection was carried out by an adult social care inspector. An expert by experience contacted people who used the service, and relatives, via telephone. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of service. The area of their expertise was in older people.

The provider had been asked to complete a provider information return (PIR) and this had been returned within required timescales. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan this inspection.

We reviewed other information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. We sought feedback from the Local Authority and other professionals.

During the inspection, we spoke with five members of staff including the registered manager. Following the inspection, we contacted 13 people who used the service by telephone and two relatives to seek their views about the service.

During the inspection, we reviewed a range of records. These included four people's care records containing care planning documentation and daily records. We looked at five staff files relating to their recruitment, supervision, appraisal and training. We viewed records relating to the management of the service and a wide variety of policies and procedures.

Updated 6 September 2017

The inspection took place on 10 July 2017 and was announced. The provider was given notice because the location provides domiciliary care services and we needed to be sure that someone would be in. A second day of inspection took place on 21 July 2017 and this was announced. We contacted people who used the service and staff by telephone on 25 July 2017 to ask for their views.

Exclusive Therapies is based in Hinderwell and provides personal care to people in their own homes within Ryedale area. The service was registered with the Care Quality Commission (CQC) in July 2016 and this was the first inspection. At the time of inspection, 67 older people used the service, some of whom were receiving end of life care. The registered provider, who was the nominated individual as well as the registered manager, was present throughout the inspection.

A registered manager is a person who has registered with the CQC 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.

Robust recruitment procedures were not in place. Staff recruitment records did not always contain full employment histories and gaps in employment had not been explored. References had not always been obtained and there was no recorded evidence of interviews taking place.

You can see what action we told the provider to take at the back of the full version of the report.

Risks to people were assessed to keep them safe from harm. When a risk was identified appropriate care plans had been developed along with an associated risk assessment which contained sufficient details to guide staff how to support people safely.

Staff had received training in how to recognise and report potential abuse and ensure people who used the service were protected from harm. Any safeguarding concerns had been appropriately managed.

Procedures were in place to guide staff on the safe administration of medicines and staff had received medicines training. The records we checked showed that people had received their medicines as prescribed.

People who used the service were supported by a regular team of staff who were reliable, friendly and who provided support in a consistent way.

All staff completed an induction to the service. A range of training was provided to ensure staff were able to effectively carry out their roles. Staff were supported by management through a regular system of supervision and competency assessments.

Staff had built strong working relationships with other professionals to maintain and promote people’s health. People were clear about how they could get access to their own GP and other professionals and staff at the service could arrange this for them.

Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005. Staff were aware of the procedure to follow if they suspected a person lacked capacity to make decisions.

Some people were supported by staff with meal preparation. Records and people confirmed that they were given choice and appropriate support was provided in this area.

People usually consented to their care and support from staff by verbally agreeing to it. People we spoke with confirmed they had input into their care planning and access to their care records.

Care plans detailed people's needs, wishes and preferences and were person-centred which helped staff to deliver personalised support. Care plans were reviewed and updated regularly. People said they were treated with dignity and respect.

The provider had an effective system in place for responding to people’s concerns and complaints. People who used the service were confident the registered manager would investigate and resolve these, wherever possible.

Feedback was sought to monitor and improve the service. The registered manager responded promptly to any feedback that was provided which highlighted areas for improvement.

The registered manager had an active role in the day to day running of the service and staff told us they felt supported by them. They were confident the registered manager would deal with any issues raised. Staff were kept informed about the operation of the service through regular staff meetings.

The registered manager carried out a number of quality assurance checks to monitor and improve the standards of the service. However, the quality assurance processes had not identified our findings with regards to pre-employment checks.