10 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was carried out by one adult social care inspector.
Service and service type:
Committed2Care Ltd is a domiciliary care agency that provides care and support to older people, younger adults, people whom have a learning disability or autistic spectrum disorder, physical disability, dementia, mental health and sensory impairment. At the time of inspection, the service was supporting 18 people with personal care.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 48 hours’ notice of the inspection visit because it is a small service, and the manager is often out of the office supporting staff or providing care. We also needed to be sure that they would be in.
Inspection site visit activity started on 1 March 2019 and ended on 7 March 2019. We visited the office location on 5 March 2019 to see the manager and office staff; and to review care records and policies and procedures. We reviewed information and spoke with people, their relatives, staff members and health and social care professionals by telephone on 1 and 7 March 2019.
What we did:
Prior to the inspection, we reviewed all the information we held about the service including notifications received by CQC. A notification is information about important events which the service is required to tell us by law.
During the inspection, we spoke to the registered manager and the nominated individual, three staff members, two people who used the service, four relatives and two health and social care professionals.
We reviewed three staff employment files, training and supervision records. Policies and procedures relating to the service. Safeguarding, accident and incident information. Three peoples care files. Quality assurance documents and feedback received by the service.
10 April 2019
About the service: Committed2Care Ltd is a domiciliary care agency that provides personal care and support to people in their own houses and flats in the community.
People’s experience of using this service:
People felt completely safe while being supported by the staff team. Risk assessment’s provided guidance to staff and gave opportunity for people to remain as independent as possible. Staff could accurately describe risks people presented and how to reduce the risks.
Staff were extremely knowledgeable of how to safeguard vulnerable people from abuse. They were able to describe signs of abuse and knew what action they would take to report such concerns. Staff told us they were fully confident the registered manager and nominated individual would act on any concerns they had. Relatives echoed this telling us, they have no concerns and would feel comfortable in approaching the registered manager with anything concerning.
People were safely supported to receive their medicines as prescribed. Staff received regular training and competency checks to ensure they were competent to administer medicines. Staff felt competent to administer medicines.
Staffing levels were consistent, and people and relatives told us, they always knew who would be supporting them. Staff were recruited safely and had the appropriate pre-employment checks were in place.
People received a holistic assessment to ensure the service could meet their needs. People and their relatives told us, they had been heavily involved in the assessment and that the process involved the service getting things right the first time. Relatives praised the assessment process saying the service had identified concerns around the safety of the persons home.
Staff were given an induction and training suitable to their job role. Staff told us, and we saw they were given time to get to know people as part of their induction. People and relatives felt this was exceptional practice as staff got to know the people they were supporting on a personal level.
People were supported to have choice around their meals and food and drink preferences. The information was clearly captured in their care plan and staff could describe people’s favourite food and drinks. Any concerns with people’s nutritional intake were reported to appropriate health professionals.
The service had close working relationships with health and social care professionals. Professionals were complimentary about the service saying the service were quick to respond to changes in people’s health and wellbeing and worked hard to build relationships with people who were unaccepting of having care and support.
The service worked in line with the Mental Capacity Act 2005 and staff had a clear understanding of how to support people with fluctuating capacity and giving support with decision making.
People and relatives told us the staff were extremely caring. One relative told us, “If they could replicate this service in every town, then there would be no concerns with the health and social care system.”
Staff genuinely cared for people and knew people well. Relatives told us they felt cared for too, as staff went out of their way to ensure they were well. The service undertook additional checks which were not part of the scheduled care to ensure people were well. Families felt relaxed knowing their relative was being well cared for.
The service promoted communication for people and looked for ways for communication to be more effective. Relative told us the communication was fantastic and they were informed of every aspect of the care and support that had been given. Staff told us the communication to them was amazing and they were continually kept updated, with nightly emails about changes to people’s wellbeing and any changes to people’s planned care were immediately communicated.
Staff had an approach of encouragement to promote independence. People felt staff genuinely wanted to care for them and felt their encouragement provided them with the confidence they needed to do as much as they could for themselves. Relatives told us with the reliability and support of the service, they had been able to continue working and have fewer concerns as they knew their relative was receiving high quality care.
People and relatives were heavily involved in their care planning and personal preference and choice was captured throughout the care plans. Care plans were very person-centred and regularly reviewed to ensure they remained reflective of people’s current needs. Staff could accurately describe people’s care plans and were able to read them and digest the information prior to supporting the person.
People and relatives felt they could easily raise any concerns although they did not have any. They felt the registered manager and nominated individual were extremely approachable and hands on in their role so would not hesitate to contact them if required. One person told us, “I had a few niggles at the beginning, but they listened and took them on board. They want to improve, they are happy to listen.”
The service provided support to people at the end of their life. The service was able to care plan for people taking into consideration any religious requirements and wishes and preferences. Staff had received training in end of life care and the registered manager had been trained in end of life care planning.
People and relatives told us they have faith in this service after feeling let down by other services and the registered manager and nominated individual were at the forefront of the service leading staff by example.
Staff felt well supported by the registered manager and nominated individual and people and relatives echoed this.
There were a number of audits in place to monitor an improve the quality of the service. The registered manager and nominated individual were fully aware of their responsibilities of their registration with the Care Quality Commission (CQC).
Rating at last inspection: This is the first inspection since the service was registered with CQC in August 2017.
Why we inspected: This was a schedule inspection planned to check that the service was providing quality care that was safe, effective, caring, responsive and well-led.
Follow up: There is no required follow up to this inspection. However, we will continue to monitor the service and will inspect again as part of our planned schedule.