Violet Care Agency Ltd

Violet Care Agency Ltd – HSCA is a domiciliary care agency providing personal care to people in their own homes. At the time of inspection, the service was providing personal care to 187 people. This includes people being supported through the enablement service. This service provides time limited support to assist people coming out of hospital to regain as much of their independence as possible.

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

Feedback about the care provided from people and their representatives was mixed. Some people told us the care they received was not of the required standard, especially when they joined the service. Other people told us they received good care once they had settled into the service and had regular care staff.

The provider had failed to manage risk when new people joined the service, in particular when they required emergency care. Systems to monitor call times and missed visits required improvement. The provider had not always ensured people’s needs were promptly assessed and staff allocated to new people had the necessary skills to meet complex needs. We received negative feedback from some professionals about staff skills and communication from the service.

The service had grown considerably in the last year. There were new staff and systems; however, this growth had not been effectively managed. Improved oversight was needed to ensure the provider understood any gaps and areas of risk. The provider was committed to resolving the issues raised at inspection and took prompt steps to address immediate concerns. They also told us they would become more involved to improve safety and increase their oversight of the service.

Care plans were detailed and personalised, however they were not always updated with information from reviews and from the new systems.

The service had enough safely recruited staff; however, improvements were needed with staff deployment to ensure people’s needs were met safely and in-line with their preferences. Staff were positive about the support they received and morale was good. The provider had a focus on nurturing and developing leaders in social care. They promoted reflection and learning.

There had been recent improvements to safeguarding practice and knowledge. The provider had recently made effective improvements following concerns raised about the administration of medicines. Staff minimised the risk of infection.

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 February 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part by notification of an incident following which two people using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk. This inspection examined those risks.

Enforcement and Recommendations

We have identified breaches in relation to governance and management of risk 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 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.

Violet Care Agency Limited is a domiciliary care agency providing personal care to people in their own homes. Some people received long term care whilst some people were provided with short term care packages aimed at supporting them to regain independence. At the time of inspection there were 44 people using the service.

People’s experience of using this service:

The service benefited from a dedicated management team who were committed to providing a good service. Lessons were learned when things went wrong to continuously drive improvements.

There were sufficient numbers of staff who had been safely recruited to meet people’s needs. However, some people expressed dissatisfaction with the timing of their care calls and experienced late visits which were not always well communicated.

Risks to people had been assessed and staff knew what to do to keep people safe from avoidable harm. People were supported to take their medicines in a safe way by staff who had been trained and assessed as competent.

Care and support was planned and delivered to promote people's safety and welfare. Staff had access to up to date information on how to support people safely and effectively in the way that they preferred.

Training, supervision and observations of staff competence was undertaken to support staff and check they had the skills and knowledge to be competent in their job role and support people effectively. However, these systems and processes required formalising to ensure consistency.

We made a recommendation about the supervision and appraisal process.

Staff were kind and caring and often went the extra mile to meet people’s needs. Staff were polite and respectful and treated people with dignity.

There were systems in place to respond to complaints and concerns which were managed appropriately and in a timely manner.

People’s opinion of the service was regularly sought and used to drive improvements and promote people’s satisfaction with the service they received.

Rating at last inspection:

Service inspected July 2018 but not rated due to insufficient evidence to make a judgement.

Why we inspected:

This was a planned inspection to provide the service with a rating. The rating now given is Good.

Follow up:

We will continue to monitor the service through the information we receive.

The service had 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.

There were enough staff to meet people's needs and staff had been recruited safely. People told us staff turned up on time and told them if they were delayed.

Risks to people were appropriately assessed and risk assessments were relevant to people's environment and needs. We have made a recommendation that recording practices around risk were strengthened. Staff reduced the risk of infection by using personal protective equipment.

Individual needs were assessed and care plans were developed to identify what care and support people required. People received appropriate support with eating, drinking and their healthcare needs. Referrals were made to community health and social care professionals when appropriate, to meet people's needs and manage their risks. The service was not currently supporting people with medicine administration but processes were in place if this was required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice.

Staff received an effective induction and a comprehensive programme of face to face training had been provided. People supported and their relatives felt staff had the knowledge and skills to meet people's needs.

People said they were involved in their care planning and were happy to express their views or raise concerns. Care plans contained initial information but more time was required to ensure they contained person centred information. People received care from staff who they considered to be friendly and caring, and who stayed long enough to provide the care people required. Staff we spoke promoted people's privacy and dignity and provided people with care and support which was individual to them.

The registered manager and staff were committed to providing a high-quality service to people. There were effective quality assurance processes in place, however we were unable to see these completed due to the timescales of people using the service. The registered manager contacted people by telephone to gain feedback and information about their initial experience of using the service.