J&R Care Services

J&R Care Services is a domiciliary care provider providing personal care to people living in their own homes, so they can live as independently as possible. At the time of our inspection there was 1 person using the service.

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

Systems were in place to ensure people were safe from the risk of abuse. Staff completed safeguarding training in recognising and reporting abuse and the provider has a safeguarding policy in place. Staff followed infection prevention and control practices and there was an infection control policy in place including procedures to follow in relation to COVID 19.

There were enough staff to meet people’s needs. There was a safe recruitment process in place to ensure staff were recruited safely and appropriate checks were completed prior to employment.

Assessments of people's needs were completed and people were involved in creating personalised care plans, which included guidance for staff on supporting people with their individual needs.

The service was caring and staff were respectful. Staff had developed positive relationships with people and treated people with kindness and compassion. The provider focused on promoting people’s independence in their own homes.

Care plans were detailed and clearly described people’s needs. Care plans were reviewed when people’s needs changed. A complaints policy was in place and people knew how to raise a concern.

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.

The provider had a good oversight of the service. There were systems in place to monitor the quality of the service. Regular audits were carried out to ensure risks were identified and action taken to minimise any risk. People’s feedback was sought to drive improvements.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 31 October 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

Not everyone who used the service received personal care. 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

The provider had not always ensured that staff who were recruited were safe to work with people by following all the checks required. Other systems which should have been in place to ensure people received a good service were not always effective or in place. There was not enough monitoring of visits to people to ensure staff were prompt and had the time to meet their needs. Care records were not routinely checked either. There were not always enough suitably trained staff available to meet the care requirements of some people.

Risks to people’s health and wellbeing were assessed and plans were in place to monitor people and to assist them in a safe manner. Staff knew how to support people safely and how to protect them from harm. Where people received assistance to take medicines, records were kept so this was done safely. When people required assistance to eat or drink, the provider ensured this was planned to meet their preferences and their current assessed need. People had support when required, in order to liaise with healthcare professionals to ensure they remained well.

People had developed caring relationships with the staff who supported them. People were appreciative and spoke fondly of staff. The provider had developed worked with other health and social care professionals to support the needs of people using the service. There were care plans in place to guide staff and these were regularly reviewed. There was a complaints procedure in place and any concerns were managed promptly.

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

Rating at last inspection (and update)

The last rating for this service was Good (published 7 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to recruitment of safe staff and governance systems at this inspection.

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

Follow up

We will request an action plan for the provider to show us 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Follow up

We will request an action plan for the provider to show us 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

J and R Care is based in Long Eaton and provides care and support to adults in the local area. 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. There were 2 people using the service at the time of our inspection and the majority of the care was being provided by the registered manager with the assistance of one additional relief member of staff.

People decided on the care they wished to receive. They consented to their care and arranged for it to be amended if their needs changed. Their privacy and dignity was respected and upheld by the staff who supported them.

Risk was assessed and plans were in place to monitor people’s health and to assist them in a safe manner. They described how to support people safely, including using equipment to assist them to move. Some people received assistance to take medicines and records were kept to ensure that this was done safely. When they required assistance to eat and drink the provider ensured that this was planned to meet their preferences

Staff had caring relationships with the people they supported and encouraged them to raise any concerns that they had; and there was a complaints procedure in place but people said that they had not needed to use it.

Staff were supported and trained to ensure that they had the skills to support people effectively. There were safe recruitment procedures in place to ensure that they were safe to work with people. They were trained in safeguarding and understood how to protect people from harm. Staff were confident that any concerns would be reported and investigated.

There were enough staff to meet people’s needs and the balance was continually reviewed as the provider intended to recruit more staff and develop the service. There were systems in place to monitor and drive improvement.

Discussions with the registered manager and people using the service demonstrated that the agency worked well with other services to ensure all needs were met. We found improvements had been made to the recruitment process to ensure people using the service were safe. People told us the agency was flexible and made every effort to meet their needs.

People that we spoke with were very positive about the quality of support that was provided to them. From discussions with all four people it was clear that the care workers provided support that was individualised to meet either their needs or those of their relatives. One relative told us that this support provided them with some respite as they felt comfortable leaving their family member alone with care workers.

All of the required information and checks had been completed and recorded on file for all members of staff employed by the service. Application forms and health forms have been completed. References have been requested and received, as well as confirmation of training undertaken during previous employment.

People told us they felt involved in their care and were aware of their care plan. They told us care workers arrived on time and stayed for the full agreed amount to time. One relative told us that they felt that staff listened to them when they made suggestions about how the care was delivered. Everyone spoken with know how to raise any concerns, but had not needed to.

We saw that procedures were in place to protect people. Training was being arranged for staff on the protection of vulnerable adults. We found that the recruitment of staff was not effective. Police checks had been completed to ensure staff were suitable to work with vulnerable adults. However, other required information such as employment history and evidence of conduct in previous employment had not been obtained and kept on file.