17 January 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
One inspector and an Expert by Experience completed this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We spoke with 5 people who used the service and 5 relatives by telephone about the quality of care the service provided. We spoke with 7 members of staff the registered manager and the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 3 people’s care records, medication records, staff rotas, training and recruitment records and the provider’s policies and procedures.
17 January 2023
About the service
Alexandras Community Care Redruth is a domiciliary care agency providing personal care to people in their own homes. The service provides support to predominantly older people who may be living with dementia and/or have a physical disability. At the time of our inspection the service was supporting over 50 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they felt safe while receiving care and relatives were complimentary of the quality of support the service provided. People’s comments included, “I would give them 10 out of 10 for the quality of care they give me. They are really caring to me”, and “I feel safe with my carers. They know what they are doing, and they talk really nicely when they are caring for me”.
Staff were recruited safely, and the service employed enough staff to meet people’s need. Rotas were well organised and included enough time for staff to travel between consecutive care visits. No planned visits had been missed.
The digital care planning and call monitoring systems alerted office staff if visits were later than planned or if medications were missed. Staff told us managers monitored this information and contacted them promptly if entries were missed.
In the evening some staff were completing care visits much faster than planned and providing some visits very early. We sough specific feedback from people about this issue, but no one reported this had adversely impacted on their welling. We have made a recommendation in relation to monitoring visit times
The provider had identified this as an area for improvement prior to the inspection and was developing plans to resolve this issue.
Risks in relation to people’s care needs and the environment had been appropriately assessed and local safeguarding procedures were well understood. Staff understood current infection control guidance and had access to good stocks of PPE.
People’s care plans were accurate and had been regularly updated. Relatives were able to access care records remotely using a secure App on their phones. People had been involved in reviewing and updating their care plans.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The registered manager led the service well and quality assurance systems were effective. Staff were well supported and complimentary of the registered manager.
People and relatives told us they would be happy to recommend the service and that they had no complaints.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 26 February 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the quality of support provider. A decision was made for us to inspect and examine those risks.
We have recommended that the provider seeks guidance from reputable experts and works with care commissioners to ensure planned evening care visits reflect people’s needs.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.