Cavendish (Homecare) Professionals Ltd

Cavendish (Homecare) Professionals Ltd is a domiciliary and nursing care agency. It provides personal care and nursing care to people living in their own houses and flats in the community. At the time of the inspection it was providing a service to 24 people.

People’s experience of using this service and what we found

People were truly respected and valued as individuals and empowered as partners in their care in an exceptional service. This had a very positive impact on people's well-being.

There was a strong, visible person-centred culture which was consistently modelled by managers and formed an essential part of how people and their relatives were treated.

The service was exceptional at helping people to express their views preferences, wishes and choices

People using the service and their relatives were very positive about the quality of care they received. They trusted the staff and felt safe with them.

Everyone had an individual plan of care which was designed in co-production with the person, their family or representative. Individual care packages were detailed, responsive and tailor made for each person.

The management went the extra mile to ensure each person’s care provision was successful and the registered manager closely monitored the initial package. This worked particularly well for people who had been discharged from hospital and were nearing the end of their life. People told us this personal approach from professional staff had supported them at a very difficult time.

All staff had clear roles and responsibilities and understood the values of the service. The registered manager and management at the service were highly visible and motivated staff.

People were involved in all aspects of their care decisions and assessing potential risks to their safety. Ways to reduce these risks had been explored and were being followed appropriately.

Staff understood their responsibilities to keep people safe from potential abuse, bullying or discrimination. Staff knew what to look out for that might indicate a person was being abused.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences. Staff and management made sure no one was disadvantaged because of their age, gender, sexual orientation, disability or culture. Staff understood the importance of upholding and respecting people’s diversity. Staff challenged discriminatory practice.

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.

Staff understood the way people expressed their views and the service made sure no one was disadvantaged because of the different ways people communicated.

Staff had been trained in the management of medicines and suitable policies and systems were in place. People told us they were satisfied with the support they received to manage their medicines where this was part of their care package.

Staff told us they felt proud to work for the agency and were very positive about the support, encouragement and guidance they received from the registered manager and management.

Everyone who either worked for the service or received a service from the agency had regular opportunities to comment on service provision and made suggestions regarding quality improvements. People told us that the management listened to them and acted on their suggestions and wishes.

People knew how to complain if they needed to and the registered manager asked if people were satisfied and happy with the service on a regular basis. The registered manager was keen to improve the service in co-production with people who used it and everyone working at the agency understood the need to be open and honest if mistakes were made.

The management team worked in partnership with other organisations to support care provisions, service development and joined-up care. This included working with local clinical commissioning groups on complex nursing care packages that successfully enabled people to come out of hospital and be cared for at home.

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 (published 26 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The provider re-registered since the previous inspection so this was our first ratings inspection of the service.

There was a registered manager at 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. The registered manager was present on both days of the inspection.

Relatives informed us that their family members felt safe and comfortable with staff and comfortable. Staff understood about different types of abuse that people were at risk from and knew how to report any concerns about people’s safety and welfare. The provider’s policies and procedures for safeguarding clearly stated that need to inform the local safeguarding team about any concerns.

Staff told us they always asked people for their consent before they provided care and support. They understood about the need to support people to make daily choices about how they wished to receive their care and how to uphold people’s legal rights in line with the Mental Capacity Act 2005 (MCA).

People’s needs were assessed before they used the service and individual care plans were developed to reflect people’s health and social care needs, wishes, preferences, and any cultural and/or spiritual needs. Care plans were regularly reviewed and updated as required. Risk assessments were developed to identify and mitigate risks when delivering care and support. Separate risk assessments were in place to address any environmental risks. Safe systems were operated to manage people’s prescribed medicines, where this support was needed.

Relatives stated that there were sufficient staff employed to ensure their family members received a consistent and reliable service. Thorough recruitment practices were used to make sure that newly appointed staff were suitably experienced to work for the service. Staff received training and supervision to carry out their roles, and reported that they were happy with the quality of training and managerial support that they received.

We received positive comments from relatives and external health care professionals in regards to how the agency supported people to meet their health care needs. Staff demonstrated an understanding of how to assist people with their eating and drinking, and they understood the provider’s required protocols to support people who were at risk of poor nutrition and/or hydration.

Staff were described as being outstandingly compassionate, considerate and kind. Staff understood how to protect people’s dignity and privacy, and we received exceptionally complimentary comments from relatives and external health care professionals about how people were cared for at the final stage of their lives.

Relatives and staff reported that the registered manager frequently visited people’s homes to check that they were being supported in accordance with their needs and wishes, as identified in their individual care plans. Following our observation during this inspection that visit reports were not in place, the registered manager had commenced the agency’s new system for recording what occurred on these visits.

Effective practices were employed to inform people and their relatives about how to make a complaint, and the complaints we looked at had been fully and sensitively investigated.

The service was well managed by the registered manager and the manager. Positive views about the service were expressed by relatives and health care professionals. Regular audits were carried out that focussed on a wide range of topics. The provider kept up to date with relevant professional issues and had implemented systems to keep staff informed.