Archived: Velvet Glove Care Limited

Velvet Glove Care Limited is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 48 people were using the service. 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

Regulatory requirements were not always met. The provider did not have a registered manager in place. The provider did not always notify the Care Quality Commission of certain events, as they were legally required to do.

People received safe care and were protected against avoidable harm, abuse, neglect and discrimination. There were systems and processes in place to safeguard people from potential harm. Staff completed training about safeguarding people from harm and knew how to report abuse

There were sufficient numbers of staff to meet people's needs safely. People were supported by staff who knew them and their needs well. The provider had followed their recruitment practices to ensure people employed were suitable to work at the service and support people.

Medicines were administered safely by trained staff.

Where the provider took on the responsibility, people were supported and encouraged to maintain good nutrition and hydration.

Staff received appropriate induction and ongoing training for their roles

The provider understood their responsibilities and worked in an open and transparent way.

The provider conducted regular checks to ensure any issues were found and resolved.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about staff training, staffing levels and management oversight of the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe, Effective, and Well Led only.

We have found evidence that the provider needs to make improvements. Please see the Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to failing to notify CQC of relevant events at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last comprehensive inspection.

This service provides care and support to people living in their own homes in the community.

Staff had a good understanding of what safeguarding meant and the procedures for reporting abuse. People had risk assessments in place to cover any risks that were present within their lives, but also enable them to be as independent as possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by the registered manager. Staffing levels were sufficient to meet people's current needs. The staff recruitment procedures ensured that appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Staff were trained in infection control, and supplied with appropriate personal protective equipment (PPE) to perform their roles safely. Arrangements were in place for the service to reflect and learn from complaints and incidents to improve safety across the service.

People’s needs were assessed and their care was provided in line with up to date guidance and best practice. People received care from staff that had received the right training and support to carry out their roles. Staff were well supported by the registered manager and one to one supervisions and observations of their practice took place.

Staff supported people to make healthy dietary choices to maintain their health and well-being. Staff supported people to attend appointments with healthcare professionals and worked in partnership with other organisations to ensure that people received coordinated and person-centred care and support.

People's consent was sought before any care was provided and the requirements of the Mental Capacity Act 2005 were met. 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 support this practice

Staff treated people with kindness, dignity and respect and spent time getting to know people. People were happy with the way that staff provided their care and support and they were encouraged to make decisions about how they wanted their care to be provided.

People were listened to, their views were acknowledged and acted upon and care and support was delivered in accordance with their assessed needs and wishes. Records showed that people were involved in the assessment process and their on-going care reviews. There was a complaints procedure in place to enable people to raise complaints about the service.

The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and any improvements identified were worked upon as required.

The service had an open culture that encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and this was used to drive continuous improvement. The provider had quality assurance systems to review all aspects of the service to drive up improvement.

The Commission carried out a focused inspection on 9 & 10 February 2017, due to concerns received in relation to shortage of care staff and missed calls. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Velvet Glove Care Limited on our website at www.cqc.org.uk

This service is registered to provide personal care to people in their own homes; at the time of our inspection there were 42 people receiving care and support from Velvet Glove Care Limited.

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 provider did not have systems and processes in place to monitor whether people had received their planned care. However these have now been implemented but we were unable to rate their effectiveness until they had been embedded in to practice.

Care staff did not always recognise that people declining their care and support was a safeguarding concern and should have been reported to the Registered Manager so appropriate action could be taken.

People received care from staff that were kind, caring and passionate about providing the care and support people wanted to enable them to stay in their own homes. People were supported to take their medicines as prescribed.

The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

Velvet Glove is a domiciliary care agency that provides care and support to people that require this help to live at home including, for example, older people with dementia care needs. When we inspected the service provided care and support to around 40 people although the number of service users frequently rise and fall depending upon local demand. The service is predominantly provided to people living in the Rothwell, Desborough, Kettering, Corby and Rutland areas of Northamptonshire, although it is not restricted to these locations.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were supported in their own homes by trained care staff that were able to meet people’s needs safely. There were sufficient numbers of care staff employed to meet people’s assessed needs.

People were protected from the risks associated with the recruitment of care staff by robust recruitment systems and appropriate training. Risk assessments were in place to reduce and manage the risks to people’s health and welfare.

People’s care plans reflected their needs and choices about how they preferred their care and support to be provided. Care staff were caring, friendly, and responsive to people’s changing needs. Care staff were able to demonstrate that they understood what was required of them to provide people with the care they needed at home.

People were treated with dignity and their right to make choices about how they preferred their care to be provided was respected. People had been kept informed in a timely way whenever care staff were unavoidably delayed, or when another member of care staff had to be substituted at short notice.

People’s rights were protected. People knew how to raise concerns and complaints. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary.

There were systems in place in place to assess and monitor the quality of the service. People’s views about the quality of their service were sought and acted upon.

We gathered evidence against the outcomes we inspected to help answer our five key questions:-

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive to people's needs?

' Is the service well-led?

This is a summary of what we found-

The information we held about the service confirmed that the manager had commenced the process to become registered with us, the Care Quality Commission (CQC). However, our records in respect of the Nominated Individual for the regulated activities, was for a person no longer associated with the service. We have asked the provider to inform us of the changes immediately. We also noted that the service was registered for the regulated activities nursing care and treatment of disease, disorder and injury which were currently dormant and may require removing from the registration certificate.

Is the service safe?

The staff we spoke with were knowledgeable about people's care and support needs. Most of the care staff told us they enjoyed their roles but were frustrated that at times they could not fit all the calls in they were asked to do. Two members of staff told us that if they questioned the timing of calls they were told to get there when they could. This meant the people who used the service were at risk of not receiving their care at the time they expected or their care would be rushed in order to accommodate everyone.

There had been some medication errors that were currently being investigated under the local authority safeguarding processes.

We have asked the provider to tell us how they will make the improvements and meet the requirements of the law in relation to planning care and medication management.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. However some of the care plans lacked the detail necessary to ensure care could be delivered in a consistent manner and met people's assessed needs.

Staff told us they did not have regular contact with the manager and had only recently had an appraisal or supervision. We did not see clear mechanisms in place to ensure the provider acted on complaints and comments made to the service by staff or the people who used the service.

Is the service caring?

We spoke to seven people who used the service, or a relative who spoke with us on their behalf. They told us most of the staff were kind and provided a good standard of care. Some people said that if a care worker was going to be late to their call they would phone them or send a text message. However, not everyone had the same experience and some people were kept waiting for care staff to arrive, which caused them unnecessary stress.

Is the service responsive to people's needs?

All of the people we spoke with told us the regular care staff treated them well and did what was expected of them. One person said, 'I don't like it as much when my regular carers are off because the staff they send don't always know what to do.' We saw that some care files had not been reviewed or written in detail, so staff who did not know a client may not have the information required to provide adequate and consistent care.

Is the service well-led?

At the time of our visit the person managing the service was not registered with the CQC but we were able to confirm that the process had commenced.

The provider had some processes in place to seek the views of people using the service and their representatives, but these were not robust.

The provider did not have effective systems to assess and monitor the quality of the service they provided and as a result they had not identified concerns with the service in a timely fashion.

We have asked the provider to tell us how they will make the improvements and meet the requirements of the law in relation to monitoring the quality of the service provided.

We spoke with members of staff who told us training was excellent and gave them a good understanding of how to meet people's needs and what to do if there were any problems. We also spoke to four of the people who used the service or their family members. We received positive feedback about the quality of care provided. One person told us, 'I am very happy with the care they provide. The carers are lovely.'

Another person told us, 'Everything is running smoothly.' However, one person did tell us that, 'More carers were needed and recruitment had been difficult.'

We found that care plans of the people who used the service were based on their assessed needs and requirements. Care plans were detailed and took account of people's individual needs and how this would be supported.

We looked and the policy and procedures the Provider had for a managing Quality Assurance and Complaints. We found that the policies would benefit from review and updating. However, we saw that the practical systems in place did mean that services were reviewed and any concerns or complaints were managed appropriately.

Following our visit we talked with family members of people who used the services. We received mixed feedback from the people we spoke to. One family member of a person who used services told us that "Communication from the office is poor." However, another person told us they were very happy with the carer who, “listened to the family” and “showed respect for X's views.”

We found the provider was in the process of developing a formal quality assurance system. This would support the checks that were already in place and would add reassurance that record keeping and information was complete and up-to-date.