29 October 2018
During a routine inspection
The service was registered with the Care Quality Commission in December 2017, therefore this inspection was the Provider’s first inspection.
The inspection was announced and started on 29 October 2018 and ended on 05 November 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. It also allowed us to arrange to visit people receiving a service in their own homes.
Not everyone using Gemcare South West (Modbury) received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 21 people receiving personal care.
There was 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.
People told us they felt safe, with one person commenting, “I feel very safe with my carers”. People were protected from abuse because staff were confident about what action to take should they suspect someone was being abused, mistreated or neglected.
People were supported by staff who had been recruited safely to help ensure they were suitable to work with vulnerable adults. People told us staff always wore their uniform and ID badges to help confirm their identity.
Overall, people told us there were enough staff to meet their needs and staff arrived on time. When staff were running late people told us, that overall, they were contacted to keep them updated. People also told us there was consistency to staffing which meant that people saw the same staff, with one person telling us, “Our three regular carers are really good”. Staff told us the registered manager was very good at making sure their schedule was geographically planned, with adequate travelling time.
People’s risks associated with their health and social care were documented and known by staff.
Staff told us environmental risk assessments were also in place to help keep them safe when working in people’s property.
People were protected by infection control practices, because staff received training in infection control and prevention and wore personal protection equipment (PPE), such as gloves and aprons.
People's medicines were managed safely. Staff received annual medicines training and people had care plans in place which helped guide staff as to what support each person needed.
The provider was pro-active and outward thinking which helped ensure learning took place when things went wrong. For example, a full review of the organisations vison and values was promoted, when a person had provided feedback about their care and support.
People and their relatives told us their needs were met by staff who had received suitable training.
New employees joining the organisation completed an induction to introduce them to the providers policy and procedures and to the ethos and values of the agency, which the provider called the ‘Gemcare Way’.
People’s individual communication needs were known by staff and recorded in their care plans. Staff told us how they adapted their own communication styles to help support people effectively. The provider had taken account of the Accessible Information Standard (AIS) in the delivery of the service. The AIS aims to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand.
People were supported to obtain help from external professionals if their care needs were changing. Staff told us they always obtained people’s consent before making a call to people’s health professionals and/or family, and always spoke with the registered manager.
When required, people were effectively supported with their nutrition and hydration. People’s care plans detailed their likes and dislikes, and any nutritional concerns.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to be part of decisions relating to their care, and people’s individual equality and diversity was respected.
People told us staff were kind, compassionate and displayed appropriate humour to help brighten their days. People told us their privacy and dignity was respected and their independence promoted.
People received personalised care and had a care plan in place which was regularly reviewed to help ensure they received care which met their needs, and was delivered in line with their wishes and preferences. At the time of this inspection no one was receiving care at the end of their life. However, the registered manager told us they had previously supported people at this time and, that care plans had been put into place which detailed the person’s wishes.
People told us the service was well managed and said that they would recommend it to others. People’s concerns and complaints were listened to and then used to help improve the service people received. The provider worked in partnership with external agencies in an open and transparent way, for the benefit of people.
The provider’s organisational values were of “Integrity, Inclusion and Competence”. The positive findings of this inspection, demonstrated that these values were at the heart of the service and underpinned in staff practice.
People received a service which was effectively assessed and monitored by the provider, to ensure its ongoing safety and quality. The registered manager told us they felt well supported by the provider.
The provider and registered manager promoted the ethos of honesty, learning from mistakes and admitted when things had gone wrong. Staff told us there was a positive and inclusive culture, and that they felt valued.
Further information is in the detailed findings below.