Archived: All Seasons

All Seasons is a small domiciliary care service that provides personal care to people in their own homes within the Leeds area. The service provides care for people living with dementia, older people, people who may have an eating disorder, physical disabilities and people over the age of 65 with a sensory impairment. At the time of our inspection there were seven people using this service.

The service had a manager who was in the process of applying to the CQC for registration. 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 using the service told us they felt safe. Care workers followed the provider’s policy to report any potential abuse or harm towards others.

Risk assessments were used to protect people from potential and avoidable risks. We saw these were updated when needs changed or new risks were identified. Accidents and incidents were reported, with actions taken to prevent reoccurrences.

Medicines were managed safely and people told us they received these on time. Medication Administration Records (MARs) were signed by care workers and ‘As required’ protocols were followed.

Staff were recruited with relevant documented checks to ensure it was safe for them to work with vulnerable adults. Staffing levels were sufficient. Planned rotas showed that people had the same care workers to support their visits when this was possible.

People using the service told us care workers were well trained and we saw evidence that care workers had participated in regular training to ensure they could meet people’s needs. Induction programmes were provided for new staff which followed the Care Certificate, which is a set of standards that social care and health workers follow in their daily working life as recommended by Skills for Care, a national provider of accreditation in training.

We found care workers were supported by management with supervisions, competency and spot checks. However, these did not follow the provider’s policy. The policy was amended on the day of inspection to reflect this.

The provider followed The Mental Capacity Act 2005 MCA legislation with capacity assessments documented and best interest meetings recorded when required. We found consent was obtained from people verbally on a day to day basis and formally at review meetings.

People were supported with their nutritional and health needs. Care plans identified people’s preferences for dietary requirements. Care files contained referrals to relevant health professionals and documentation of actions taken to support people’s needs.

Care workers were aware of people’s need for privacy and respected their dignity upon visits. People and care workers had good relationships and this was reflected with positive comments from people using the service.

People using the service told us the care workers provided explanations of what they were doing during their visits and asked their permission to carry out support work.

We found people were supported to remain independent and when additional support was required the provider would action relevant referrals to support individuals.

Care files were person centred focusing on peoples preferences, which included likes and dislikes. People told us they were always offered choices and made decisions about what to wear or to eat.

Initial assessments were completed and care files contained people’s information about the care they needed. Regular reviews took place with people using the service and their relatives.

The provider managed complaints effectively with an immediate response, investigations and written outcomes. We also found several compliments which had been received which were very positive about the care being provided.

Care workers told us they felt supported by the management and described the working relationship as a ‘family’.

The manager had not registered with the CQC although they had been in the post for 12 months. The manager had taken steps to apply at the time of our inspection.

Audits were completed on a weekly or monthly basis to ensure the quality of the service was being monitored. Annual surveys were completed by people who used the service and care workers with positive feedback received.

As the service was small, communications were often by text message, although staff meetings sometimes took place if needed.