28 December 2018
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.
This inspection took place on 25 and 26 July 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. It included visiting the office and telephone calls to people who used the service. We visited the office location on 25 July 2018 to see the manager and office staff; and to review care records and policies and procedures.
In preparation for our visit we reviewed information that we held about the service. This included the action plan completed by the provider following our last inspection. As well as notifications (events which happened in the home that the provider is required to tell us about) and information that had been sent to us by other agencies including the local authority contracting and safeguarding teams. We also used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We spoke with the registered manager, the manager and two care workers. We also spoke with two people who used the service and two of their relatives.
We looked at a range of documents and written records including four people’s care files and two staff recruitment records. We also looked at information relating to the administration of medicines and the auditing and monitoring of service provision.
28 December 2018
The inspection took place on 25 July 2018 and was announced.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Not everyone using Evergreen Care Trust receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The service was providing personal care for seven people.
There was a registered manager for the service. 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.
This was the first inspection for the service following the registration with the Care Quality Commission.
The provider was dedicated to providing an exceptionally high quality of care for people. They understood that to do this they needed a workforce who had received appropriate training and had the time to deliver safe care. People told us that the care was outstanding and that it met and exceeded their expectations.
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. Where people did not have capacity to make decisions the provider worked with others to make decisions in their best interest. We saw that this had enabled people to continue to live in their own homes.
The provider had engaged with educational institutions to provide high quality training for the staff. They had also identified where gaps in the training did not support staff and were working with the educational institutes to develop training to specifically support staff to provide care to people in their own homes.
There were enough staff to meet people’s needs and safe recruitment practices were followed. The rotas ensured that staff had time to travel between people’s home and to provide care in a calm unrushed manner. Staff had time to get to know the people they supported and rotas ensured that people received their care from a small group of staff who knew their needs.
People received an assessment before they started to use the service so that the registered manager could be sure that the service could meet their needs in line with best practice guidance. Care plans accurately recorded the care people needed and people had been included in developing their care plans. Staff ensured that people had access to their preferred activity when they left and had the ability to refer people to the provider’s wellbeing and befriending services.
Risks to people were identified and care was planned to keep people safe. Medicines were safely stored and people received their medicines in a timely fashion. Staff understood how to keep people safe from the risk of infection and protective equipment was available for them. People were supported to maintain a healthy weight and encouraged to drink plenty of fluid. If needed their food and fluid intake was monitored and action was taken when concerns were raised.
The provider had proactively engaged with a number of NHS and local authority initiatives to look at how care could be provided more seamlessly across agencies to provide a better level of support to people and avoid hospital admissions. In addition the provider had helped to set up two social care organisations, one so that people could network and make contacts and one so that the charity sector had a united voice when responding to NHS and local authority initiatives.
As well as providing a high quality of care to people the provider was also clear that it needed to look after and develop their staff. They had a number of systems in place to ensure that people enjoyed a good work life balance and that their contribution to the organisation was recognised. There were systems in place to monitor the quality of care provided and people using the service and their relatives were encouraged to raise any complaint or concerns.