Archived: Footcare Service

Footcare Service is a domiciliary care agency registered to provide personal care to people in their own homes and in community clinics. The personal care provided by this service is limited to footcare. The footcare service is provided to over 500 people in the Chorley and West Lancashire areas, under the supervision of an NHS Podiatrist.

People received the service in their own homes and some attended one of the community clinics the service offers in community buildings.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People who used the service told us they felt safe when staff members were in their homes. Staff had received training in safeguarding and knew their responsibilities to report any concerns. The service also had whistleblowing and lone working policies in place.

Risk assessments were in place to keep people safe. These were reviewed and updated regularly or when changes occurred.

Recruitment systems and processes in place were robust. We saw references, identity checks and Disclosure and Barring Service checks were completed before staff were employed.

People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

New staff members were expected to complete an induction when they commenced employment. Their competence was checked regularly by a NHS podiatrist. Training courses were available to staff which were relevant to their roles. Staff members told us, and records confirmed, that staff members received supervision and appraisals on a regular basis. All staff members told us they were able to discuss any training requirements they had.

Feedback provided by people showed that staff were kind, caring and supportive of people who used the service.

The service delivered person centred care. We saw person centred care plans were in place and reviewed regularly.

The service had a complaint’s procedure in place. No complaints had been received since our last inspection.

Accidents and incidents were reported to management. This meant they were able to see if appropriate action had been taken by staff to ensure people were kept safe.

The registered manager had processes and systems in place to monitor and improve the quality of the service.

We saw regular staff meetings were also held. Staff told us these were regular and they were able to bring up topics for discussion.

The service was meeting all relevant fundamental standards.

Further information is in the detailed findings below.

The service was last inspected on 6 August 2013 where it was found complaint with the regulations inspected. This is the first inspection under the new methodology, where the service has been provided with a rating under the Health and social Care Act 2008 (Regulated Activities) Regulations 2014.

At the time of the inspection the service was providing a nail cutting service to 605 people predominantly in the Chorley area but also expanding into the West Lancashire area. Some people receive the service in their own home and some attend one of the six clinics the service offers in community buildings or care homes.

The provider is also registered to offer a home help service which at the time of the inspection was not in operation due to no demand for personal care support.

The provider had a manager who was in the process of registering with the commission. 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.

We found the service undertook risk assessments for the service delivery including any location from which it was delivered. The provider had a set of safeguarding procedures which staff we spoke to understood how to implement

Policies and procedures were in place and followed for the reduction of infection control and cross contamination. This included each person using the service having their own nail cutting equipment and staff wearing and disposing of the appropriate personal protective equipment after each appointment.

We noted recruitment files were missing some of the information required under schedule three of the Health and Social Care Act 2008 (HSCA 2008). This information ensured that staff in post were fit and suitable candidates. Most staff had been in post prior to the HSCA and the provider had undertaken an audit of personnel file information which identified some gaps. The provider was in the process of accessing the required information.

The provider had a good set of mandatory training and was in the process of sourcing the care certificate for all Age UK staff. Staff at the service also undertook specific training and competency testing for the role they were undertaking.

We saw that the service worked mostly with implied consent from people having their nails cut. The provider was reviewing available information to support people they supported who were living with dementia to ensure they were working within the principles of the Mental Capacity Act 2005.

People we spoke with told us all the staff were very pleasant and they were very grateful of the service. The provider told us and we saw some very positive feedback on the service people received. We were also told if the service required the support of a translator for someone wishing to use the service whose first language was not English then one would be provided.

When people first referred to the service a comprehensive assessment was completed by the podiatrist. This would be reviewed by staff at every subsequent visit and formally again by the podiatrist 18 months after service initiation.

A complaints procedure was in place and people had access to a leaflet for them to feedback their experience on the service. Staff also have available copies of information for people to complete ‘If things go wrong’.

We saw a set of values and provider ethos on the notice board in the provider offices. We were told how a new appraisal system had been developed with the values of the service at the core. Staff were supported by an employee assistance group and staff at the service were active in this group. This helped ensure that things that were important to the staff of the service were highlighted as required.

The provider had recently developed a quality improvement plan for the service and we were told that the feedback from the inspection would form part of this plan going forward.

Standards we looked at took account of the care and welfare of people using the service experienced, how complaints were managed and responded to, how staff were supported and what access they had to training and development. We also looked at what quality assurance systems the agency used to monitor and develop its service provision.

People we spoke with were positive about the service they received. One person told us, 'Would recommend to other people. Very friendly staff'. Another person said, 'Staff do a very good job. Always pleasant and cheerful'. We spoke with a member of the staff team, they told us they had worked for the service for some time. They told us it was well managed. They felt supported and they liked the work they undertook.

We examined some care records of people using the foot care service and also viewed comments and feedback they had provided. The feedback was very positive and included;

'To say I am pleased with the service is an understatement.'

'It's so good to be with people who are kind and helpful to others.'

'They are very careful, when she has finished I feel like I could walk for miles!'

We looked at a number of standards including how the service promoted the care and welfare of people and how they safeguarded people from abuse. We found that the service was compliant in all the areas we assessed.