Archived: 1st Homecare (Oxford) Ltd

1st Homecare is a domiciliary care agency that was providing personal care to 37 people at the time of the inspection. Not everyone using the service received personal care. The 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

The service was exceptionally responsive to people's needs and immediately acted upon any occurrences. Staff went above and beyond the call of duty to provide individualised, person centred, high quality care. The service listened to people and implemented changes to the service to accommodate their needs and wishes. People and their relatives told us the service provided excellent care that exceeded their expectation.

The management and leadership of the service were exceptional. The management team had an excellent understanding of the provision of care and support for people with complex needs. There was an excellent culture within the service which promoted clear values and a drive to provide high quality care. The high quality, compassionate culture was embedded through every part of the organisation and ensured every person received exceptionally person-centred care.

People told us staff had enough time to support them and they had not experienced any missed visits. Staff were aware of what might be a safeguarding concern and explained how they would raise it. Risk assessments ensured people were supported to manage risks in their daily lives. There were systems in place to ensure people received their medicines safely. Staff were recruited safely.

Initial assessments were carried out to ensure people's needs could be met. These were used to produce personalised care plans and to guide staff on how to best support people. People were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff acted in people's best interests; the policies and systems in the service supported this practice. Staff had the right skills and experience to meet people's needs. A comprehensive induction and training programme were completed by all staff.

People and their relatives told us staff were caring, kind and polite. Staff treated people with dignity and respect. People and their relatives told us they felt able to express their views and had been involved in making decisions about people's care.

The provider had an up to date complaints procedure and people and their relatives told us they would know how to make a complaint if they needed to.

People, their relatives and staff were complimentary of management team. The provider had effective quality assurance systems in place which were used to drive improvements. The management team promoted a caring ethos at the service, which was supported by passionate and dedicated staff.

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 (21 March 2019).

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.

People’s experience of using this service:

• People supported by 1st Homecare continued to receive safe care from skilled and knowledgeable staff.

• The provider sought training to ensure staff were knowledgeable to look after people with complex needs such as learning disabilities, autism and dementia.

• People and relatives told us staff were kind and dedicated. They said staff knew people well and treated people with dignity and respect.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

•1st Homecare remained well-led. People, relatives and staff were complimentary of the registered manager’s leadership. The provider had effective quality assurance systems in place which were used to drive improvement.

Rating at last inspection:

At our last inspection we rated the service good. Our last report was published on 1 December 2016.

The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection remained “good”.

More information is in our full report.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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.

Leadership within the service was open and transparent and promoted strong organisational values. This resulted in a caring culture that put people using the service at the centre. People, their relatives, staff and healthcare professionals were complimentary about the management team and how the service was run.

People who were supported by the service felt safe. Staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicines as prescribed. There were systems in place to manage safe administration and storage of medicines.

There were enough suitably qualified and experienced staff to meet people needs. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Staff were aware of people’s needs and followed guidance to keep them safe.

Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager) to help them meet the needs of the people they cared for.

The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of the MCA.

People’s nutritional needs were met. People were given choices and were supported to have their meals when they needed them. Staff treated people with kindness, compassion and respect and promoted people’s independence and right to privacy. People received quality care that met their needs.

People were supported to maintain their health and were referred for specialist advice as required. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible.

Staff knew the people they cared for and what was important to them. Staff appreciated people’s unique life histories and understood how these could influence the way people wanted to be cared for. Staff supported and encouraged people to engage with a variety of social activities of their choice in the community.

The service looked for ways to continually improve the quality of the service. Feedback was sought from people and their relatives and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

The registered manager informed us of all notifiable incidents. The registered manager had a clear plan to develop and further improve the service. Staff spoke positively about the support and leadership they received from the management team.

People we spoke with were very positive about the quality of the care they received. People told us that they knew who to contact within the agency if they had any concerns.

We saw that people were involved in decisions about their care and treatment. We saw that individuals were respected and consulted about how their care was delivered. People were treated with dignity and respect. For example, one person told us, 'they meet my needs wonderfully'.

We looked at how safe the service was. We spoke with people about their experiences. A person who used the service told us, 'I feel very safe in their care'.

The agency had a robust recruitment and selection policy. Care workers received appropriate professional training, development and induction. We asked care workers if they had access to training. One care worker said, 'I have had lots of training, safeguarding and whistleblowing which is an important part of the training'.

You can see our judgements on the front page of this report.

People told us that they had a choice in who provided their care and could request a change if care was not being given in the way they wanted.

People we spoke with told us that their care was regularly reviewed and that if there were problems they were confident that the manager would investigate them. People told us that they would be listened to and that action would be taken if they had a complaint or concern