Archived: Theo Langston Care- Home Care Services Limited

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We checked people's care plans and found them to be detailed, relevant and up to date. We spoke to care staff and they demonstrated that they were aware of people's health needs and personal preferences. This meant that people were receiving safe and appropriate care.

We spoke to several people who received care from this agency. People told us they felt safe with the carers who supported them. Comments included, 'I trust the carers' and 'I feel safe with them.'

We saw that the agency had appropriate safeguarding procedures in place. These were detailed and fit for purpose. We checked staff training records and saw that most staff had received recent training in safeguarding vulnerable adults. We spoke to staff and they demonstrated that they understood their role with safeguarding vulnerable people and knew what action to take should it be necessary to do so.

We concluded that people who received care and support from Theo Langston Care were safe and protected from harm and inappropriate care.

Is the service effective?

People's needs were assessed and care and support was planned and delivered in line with their individual care plans. We found that each person had their own individual plan of care and support which included assessed needs, risk assessments and useful information about their health conditions. These records were neatly presented, detailed and up to date.

Care staff told us that they were well trained, competent and able to meet the needs of the people who used the service. Training records showed that staff had received appropriate training in a number of relevant topics, including: health and safety, infection control, safeguarding vulnerable adults and medication.

People and their relatives told us that they were happy with the care they received and the care staff who supported them.

We concluded that care staff had the appropriate skills and knowledge to ensure that people received safe, effective and appropriate care and support.

Is the service caring?

People were supported by kind and attentive staff. It was apparent during our observations and time spent talking to people who received care, that staff were attentive, patient and caring towards them. Staff treated people with respect and dignity. People commented, 'They are wonderful to me, I couldn't do without them' and 'Everything is fine I have no complaints.'

We spoke to relatives of people who received care and support. They were complimentary about the standards of care being delivered and the competence of staff delivering care and support.

We concluded that people received good care which was delivered with compassion and respect for their dignity and human rights.

Is the service responsive?

There were good arrangements for making sure that people could express their views about the service. We saw records including a customer satisfaction survey (questionnaires) which showed that people had been consulted about their preferences and the care and support they received. This meant that people were supported in promoting their independence and had regular opportunities to discuss and influence the care and support they received.

We found that care staff had regular meetings with the management team at the agency where they were able to discuss their training and development needs, welfare and any concerns they might have about the people they were caring for.

We found that the agency had a comprehensive complaints policy. However we found evidence that a relative of a person receiving care had made a number of complaints to staff about the care his relative was receiving. We noted that although action had been taken to deal with the issues raised, no entry had been made in the agency's complaints records and no formal investigation had been initiated. This meant that the agency had not followed the procedures set out in its complaints policy.

We concluded that people and their relatives who receive care and support from this agency were not always listened to in a way that responded to their needs and concerns.

Is the service well-led?

Records show that Theo Langston Home Care Services has not had a permanent Registered Manager for more than 12 months. It was also apparent that the agency had experienced some difficulties retaining staff. We spoke to the provider about this and received some re-assurance that arrangements were in hand to have a new registered manager in the near future.

We found that the two care co-ordinators employed at the agency were experienced and competent. However records showed that they had only been working at the agency for just a few months.

It was clear that significant improvements had been made at this care agency since our last inspection in May 2013. Records showed that the provider had an effective system to regularly assess and monitor the quality of service that people received.

We concluded that the leadership at Theo Langston Care is currently effective and people are receiving safe care and support and being treated with respect, care and consideration.

People told us that they were happy with the service provided by Theo Langston Care and felt safe with the staff who provided their care and support. Comments included, 'They are very good, I always have the same carer.' Relatives were also complimentary about the care and support being provided. Comments included 'My relative is happy with them, she would say if she wasn't.'

People's needs were not properly assessed and care and support was not always planned and delivered in line with their individual care plans. Care plans had insufficient detail about people's needs and some risk assessments had not been completed in relation to people at risk of falling.

We found that care staff did not have regular supervision or appraisal meetings with their manager. Some members of care staff had not received appropriate professional training and had commenced working as a carer at Theo Langston before all appropriate vetting checks regarding suitability had been undertaken.

People who used this service were not adequately protected from the risk of abuse, because the provider had not taken reasonable steps to prevent abuse from happening. People using the service or their relatives were not asked for their views about the care and support that was provided.