Archived: Franklin Domicliary Care Agency

Franklin Domiciliary Care provides supported living to people in their own homes which was within a single block of flats named Carpenter Court. People who use the service have mental health needs. At the time of our inspection the service supported ten people who lived in single occupancy properties at Carpenter Court. The service provided domestic and social support with some personal care to a small number of people. Franklin Domiciliary Care Agency employs six support staff and a registered manager. The agency office is based on site.

There was a registered manager at this service. 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 who used the service and their relatives told us they felt safe and staff knew how to protect people from avoidable harm. Risk assessments and risk management plans were in place. They contained detailed guidance for staff about how to minimise the risk of harm.

There had been a period of high staff turnover, but this had begun to settle down due to the recruitment of new staff. There were sufficient staff employed to cover the number of hours provided across the service. The service used other care staff to fill in gaps in rotas within the organisation and who knew people the agency provided a service for. This meant that people who used the service were provided with a consistent service.

Staff told us the registered manager and other senior staff, employed by the service, were supportive and approachable. They also confirmed to us that the on call arrangements were well organised, and that they could seek advice and help out of hours if necessary. This meant there was good oversight of the issues across the service, and staff were confident about the management structures and who to seek advice from.

When new staff were recruited we saw the service had robust checks in place to ensure people employed were suitable to work with people who used the service.

Care plans were comprehensive and had associated risk assessments. Medicines were safely managed. Some of the people who used the service were supported with taking their prescribed medication and staff told us they were trained and competent to assist people with this.

Staff described feeling well supported by their managers. We saw evidence of supervisions taking place on a routine basis. This meant staff had the opportunity to reflect on and develop their practice.

People received support from staff who had access to appropriate training and knew how to meet people’s needs.

People were protected because staff at the service were aware of and followed the principles of the Mental Capacity Act 2005.

People had access to appropriate healthcare professionals and had a health action plan. This meant people’s health care needs were being appropriately supported.

There was access to varied and balanced diets, people were involved in planning and, where possible, making meals.

People were supported to be as independent as they could be and some people worked in local community organisations.

People who used the service and their relatives understood how to make complaints. Complaints were responded to appropriately by the registered manager.

Systems and processes were in place to monitor the service and make improvements where they could. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages. Policies and procedures had been updated to ensure they were in line with current guidance and legislation.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary please read our full report.

This is a summary of what we found:

Is the service safe?

We spoke with people who used the service who told us they feel safer because support workers from this service supported them well. One person said 'I get the support I need and it is very good.'

People told us that they felt their rights and dignity were always respected.

We looked at the agency's risk management plans. Records we saw showed us that people and staff were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives, and what support they received from the agency. The service had completed comprehensive risk assessments for the environment and people's physical and mental health.

People did receive their medication as prescribed. People who used the service could administer their own medication safely with minimal support from staff.

We looked at the service's recruitment practice and found this to be safe and thorough. No staff had been subject to disciplinary action. Staff only commenced working in people's homes once the necessary checks had been carried out.

The care quality commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Arrangements were in place for senior support workers to receive updated training to confirm their understanding of when an application should be made and how to submit one.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in developing their plans of care. One person explained that they had hand written their own care plan, which was then followed by staff from the agency. One person 'I get the support I need and I am supported well.'

People said that their care plans were up to date and reflected their current needs. Records we saw supported this. From speaking with staff they were able to demonstrate a good understanding of people's care and support needs and knew people very well.

Staff had received training to meet the needs of people they support in the community. New members of staff had had induction training when they began working at the service. They had also completed mandatory training so that they could work safely with people.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People we spoke with told us that they were also involved and participated in the recruitment of new members of staff. This demonstrated that people receiving a service were included in how the agency was managed.

Is the service caring?

People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. One person told us 'The staff are all really caring.' Another person told us 'The staff are all ok. They are all nice people.'

When speaking with staff it was clear that they genuinely cared for the people they supported.

Is the service responsive?

People's needs were assessed before the agency provided a service to them in their own home. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People we spoke with told us they knew how to make a complaint if they were unhappy. People confirmed that they were given a complaints booklet, which outlined how to make a complaint. This booklet was also available in an easy read format. People also told us that complaints would be investigated and action taken as necessary. One person told us 'I would speak to someone in the office and they would deal with it.'

Is the service well-led?

This agency is a small service and supports people to live their lives as independently as possible with the necessary support to achieve this. We saw that there was an effective and robust quality assurance system in place which meant that the service was learning from any audits and that there were continuous improvements to the service.

Effective management systems were in place to promote and safeguard people's safety and welfare.

Relatives we spoke with told us they thought the service ran well. One relative said 'The staff are very supportive. They (staff) ring me if they have any concerns about X.'

We saw from care files that the service worked well with other health care professionals and services to make sure people received the care they needed in a joined up way.

We visited three people who used the agency in their own home and spoke with four relatives and one care manager by telephone. Feedback was positive with comments including 'My relative is happy with the service' and 'My daughter is very well looked after.'

We saw from people's care plans that people were supported to live as independently as possible. The agency had carried out an assessment of the needs of each person, and kept this under review, to enable appropriate care and support to be given.

The service had in place policies and procedures covering safeguarding and the protection of vulnerable adults. Staff were familiar with safeguarding and whistle blowing procedures and knew what to do in the event of abuse being suspected.

Records we looked at also confirmed that staff received good training in areas such as safeguarding adults, infection control and first aid. They also told us that they had received good induction training when they first began working at the home.

The provider had put systems in place to make sure people were safely cared for. This included policies and procedures, induction training for staff and quality monitoring systems.