Background to this inspection
Updated
17 October 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 was planned to check 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.
The inspection took place on 22 August and 5 September 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available to respond to our queries. The registered manager was not available at our first visit so we returned to meet with them at a later date to gather more information about the running of the service.
The inspection team consisted of one inspector and one expert by experience, who contacted people and relatives by telephone to seek their views on the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert at this inspection had experience of caring for an older person.
We visited the agency’s office and spoke with the registered manager, the general manager, the client care manager, the clinical lead nurse, the team leader and other office staff responsible for training, rotas and recruitment. We visited the homes of two people who used the service and met with them plus the staff supporting them on that day. We spoke on the telephone with nine people who used the service and eight relatives. We also received emails from eight family members. We had contact with eight care staff by email, phone or in person. We also had email contact with three professionals to gather their views about the service being provided.
We reviewed all the information we had available about the service including notifications sent to us by the manager. Notifications are information about important events which the provider is required to send us by law. We also looked at information sent to us from others, including family members and the local authority. Before the inspection, the provider completed a Provider Information Return (PIR). This 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. This information helped us to plan what areas to focus our attention on for the inspection.
We looked at five people’s care records and four staff records. We examined information relating to the management of the service such as health and safety records, personnel and recruitment records, quality monitoring audits and complaints.
Updated
17 October 2017
The inspection took place on 22 August and 5 September 2017 and was announced.
Caring 4 U is a domiciliary care service that provides personal care to people living in their own homes. The service serves the local community around Braintree. They provide a service for adults, who are predominantly older and who may be living with dementia or adults who have a physical or learning disability. At the time of our inspection there were approximately 50 people using the service.
There was a registered manager in post. 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. The registered manager had appointed a general manager to assist them in the daily running of the service.
The manager had addressed concerns we had raised at our last inspection regarding the management of risk. The risk assessment process had been improved so that staff now had better quality information to enable them to support people safely. There was a pro-active approach to safeguarding and staff worked well with professionals to minimise risk.
Staff were safely recruited and well deployed so that they had enough time to meet people’s needs. There were electronic systems in place to record the administration of medicine which were well understood by staff and managers and provided accurate, current information of the support being provided with medicines.
Staff were well supported in their role. There were effective and innovative measures in place to develop staff skills, such as access to high quality clinical information, which enabled them to meet a complex range of needs.
There was a good understanding of people’s capacity to make decisions. The service met its responsibilities under the Mental Capacity Act 2005 and ensured decisions were made in people’s best interests.
There was a good awareness about people’s abilities, needs and preferences when supporting them to eat and drink. Staff worked extremely well with other professionals to meet people’s needs which enabled people with complex needs to be supported to continue living in the community.
The manager enabled staff to develop caring relationships with the people and families they supported by ensuring consistent rotas and enough time to meet people’s needs in a relaxed manner. Staff knew how to communicate with people and what their preferences were. Privacy and confidentiality was promoted in the office and out in the community.
Support was flexible and tailored creatively around people’s needs. The service had been designed so that people’s needs were central to the way staff were deployed. Care plans were detailed and person-centred and equipped staff with the necessary information to meet people’s needs. There were improved systems to ensure people’s care was reviewed as required. There was a pro-active approach to resolving people’s concerns.
The manager delegated well and ensured the service was run efficiently. Office and care staff understood their roles and functioned well as a team. There was a commitment to innovation and best practice, especially in the use of online technology and the development of clinical skills. There were effective systems in place to support staff and to monitor the quality of the support people received.