Xtra Healthcare

Xtra Healthcare is a domiciliary care and supported living service providing care to people in their own homes. At the time of the inspection the service was primarily proving support to people with learning disabilities and autism in supported living. 14 people were being supported at the time of the inspection.

Not everyone who used the service received personal care. 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.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of Safe and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: People were supported to achieved good outcomes. There were clear communication systems within the service to support this.

Personalised risk assessments gave clear strategies for staff to follow in keeping people safe, whilst enabling people to be as independent as possible. Staff were skilled in recognising signs when people experienced emotional distress and knew how to support people to keep them safe.

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.

Right care: The care and support people received was tailored to their individual needs. Staff treated people with dignity and respect and promoted their right to privacy.

Right culture: The culture within the service empowered people who used the service. The staff team promoted inclusive practices which supported people to live a full life. Their rights and aspirations were promoted.

The management team had the specialist skills, knowledge and experience to perform their roles and had a clear understanding of people's needs. Systems and processes were in place to monitor the quality and performance of the service.

There was good communication between, staff, management, people and families. People and staff were listened to and encouraged to give their feedback about the service. The provider was committed to driving improvement and provide the best care and outcomes for people.

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 2 April 2021).

Why we inspected

We received concerns in relation to staff recruitment, staff skills and training and oversite of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Xtra Healthcare on our website at www.cqc.org.uk.

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.

Xtra Healthcare is a domiciliary care agency providing personal care to people living in their own homes. At the time of inspection four people were receiving personal care.

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

People were supported and cared for safely. Risk assessments were in place and reviewed regularly and as people’s needs changed. Staff understood safeguarding procedures. Safe recruitment practices were followed to ensure staff were suitable for their roles.

There were enough staff to meet people’s care and support needs. People were supported with their medicines and good infection control practices were in place.

People’s care files contained clear information covering all aspects of their care and support needs. Staff had a good understanding of people’s wishes and individual preferences. People’s personal preferences, likes and dislikes, communication needs and links with family were all considered within the care plans. Staff received training to meet people’s needs.

Where required, people were supported with their eating and drinking to ensure their dietary requirements were met. People were supported to use health care services when needed.

People received support from reliable, compassionate staff. Staff enjoyed working at the service and there was good communication and team work. Staff were caring in their approach and had good relationships with people and their relatives. People were treated with respect. Staff maintained people’s dignity and promoted their independence. Consent was sought before care tasks were undertaken.

The registered manager and management team monitored the quality of the service provided. They were aware of their legal responsibilities and worked in an open and transparent way. People and their relatives knew how to make a complaint.

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.

Rating at last inspection

The last rating for this service was good (published 2 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per out re-inspection programme. If we receive any concerning information we may inspect sooner.

The head office in Northampton for Xtra Healthcare Limited provides personal care for adults living in their own home, including people living with dementia. At the time of our visit there were four people using the service.

The service did not have a registered manager. The provider was managing the service and a new manager, who had already been recruited, was due to commence the following day after our inspection visit. 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 felt safe and were protected from the risk of avoidable harm. Staff were knowledgeable about the risks of abuse and there were suitable systems in place for recording, reporting and investigating incidents. Risks to people’s safety had been assessed and staff used these to assist people to remain as independent as possible. There were sufficient staff employed to meet the range of care and support needs of people who used the service. Staff had been recruited using effective recruitment processes. At the time of our inspection there was no one using the service that required support to take their medicines. However we found that systems were in place should this service be required.

Staff were knowledgeable about the needs of the people they cared for. They attended a variety of training to keep their knowledge and skills up to date. They were further supported with regular feedback from the provider about their work performance. People who used the service were encouraged to make their own decisions and staff followed the principles of the Mental Capacity Act 2005. People were provided with nutritional support if this was an assessed part of their package of care. Staff would be available to support people to access healthcare appointments if needed.

There were positive relationships between people, their families and members of staff and they were treated with kindness and compassion. People’s rights in making decisions and suggestions in relation to their support and care were valued and acted on. The privacy and dignity of people was promoted by staff and they treated people with respect.

People received person centred care that met their needs and centred around them as individuals. People’s needs were assessed before a care package commenced and care plans gave clear guidance to staff on how people were to be supported. Records showed that people and their relatives were involved in the assessment process and review of their care. The service was flexible and any additional support was provided where necessary. People knew how to make a complaint. There was a complaints procedure in place which was accessible to all.

There were quality monitoring systems and processes in place to make positive changes, drive future improvement and identify where action needed to be taken. There was an open culture and a clear vision and staff told us they were proud to work for the service. People and their relatives expressed confidence in the provider’s ability to provide person centred care and good oversight and leadership of the service.