Before our visit we gave the provider notice of our visit forty eight hours before we visited the office. During our visit we conducted face to face interviews with seven staff, spoke with the manager and deputy manager and looked at care records. We spoke with nine people on the telephone following our visit. All the people we spoke with gave positive comments about the service provided. The methods we used enabled us to establish an overview of the experiences that people had to determine the standard of care provided and the satisfaction of the people who used the service. Our conversations with people helped us to answer our five questions we always ask.
Is the service safe?
All the people we spoke with told us that they felt safe with the staff that supported them. One person told us, 'I have no problem with the carers, they are very kind and caring, I am happy with them.' Another person told us,'I have been with the agency for a while and I like the staff who come to me, they are very good.'
All the staff we spoke with confirmed that they had received training on how to protect people and understood what safeguarding people meant. In addition they received updated training when required.
We saw that people had an assessment of their needs and associated risks. A plan of care was completed which enabled staff to offer care and support to people in a safe way. Staff told us and records sampled showed that they had received training and support that enabled them to deliver care safely.
CQC monitors the operation of the Deprivation of Liberty Safeguards, which applies to care homes. This is a domiciliary service. No one using this service was subjected to an application to deprive them of their liberty. Staff spoken with understood about people making decisions and how to respect rights. For example, supporting people to make choices about their care.
All the people we spoke with told us they were happy with the care they received and would speak with the office staff if they had any concerns. All of the staff spoken with were able to tell us about the needs of the people they were supporting. One staff member told us, 'I have been with the same person for years so I know them really well. I love my ladies they are like family. I treat people like I would my own mom, that's the way it is.'
Is the care effective?
People spoken with told us and records sampled showed that they had been involved in an assessment of their needs and were able to tell staff what support they needed. This meant that people were able influence the care they received.
All staff spoken with were able to tell how they supported people and gave them choices about their care. All staff told us they asked people what they wanted at each call. People confirmed that staff always asked them what they wanted. All the people spoken with told us that they were supported by the same staff on most care calls which meant people received continuity of care from staff they felt comfortable with.
Is the service caring?
People told us they were happy with the care they received. We saw from daily records sampled that where staff had concerns about people's health, additional support was provided. For example other health care professionals were made aware and advice sought. One person told us, 'I think I get a good service, they (staff) mostly come on time, it is very rare they don't come, the office let me know If they are going to be late.' Another person told us, 'Sometimes at weekends the staff are a little late but I don't mind it's not often.' We saw that reviews of people's care needs were completed to ensure that the service provided to them met their needs.
Is the service responsive?
All of the people told us that staff did what they wanted them to do. They told us that if their care workers were going to be late they were kept informed either by the care staff or the office. One person told us, 'Sometimes they change without telling me, but this is now sorted because I told the office and now I have the same staff'
Records sampled showed that there were systems in place to gather the views of people so that the service was developed taking into consideration the views of staff and people who received a service. We saw that courtesy calls were made on a monthly basis. We saw where concerns or issues had been raised the manager investigated and responded to people with an outcome. This was confirmed by one person we spoke with who told us, 'If you phone the office they are very good in sorting things out'.
Is the service well led?
There is a registered manager in post who has day to day responsibility of the service provided. This meant staff should have the guidance and support to meet people's needs. We saw that reviews and courtesy telephone call and visit were made on a regular basis with people who used the service to gain their views about the service and make suggestions for improvement. All the people we spoke with told us that the manager and staff always listen. This meant the provider monitored the service and took people's views into consideration when making improvements.