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Archived: Always Better Care Limited

Overall: Requires improvement read more about inspection ratings

202 Nutgrove Road, St Helens, Merseyside, WA9 5JP

Provided and run by:
Always Better Care Ltd

Important: This service was previously registered at a different address - see old profile

All Inspections

2 & 20 November 2015

During a routine inspection

This was an announced inspection carried out on 2 and 20 November 2015.

Always Better Care Limited is a small domiciliary care agency based in St Helens. It offers care and support to people in their own home including personal care. Support in everyday activities such as shopping can be provided, which helps people to live as independently as possible. The agency has offices based in St Helens close to public transport routes. At the time of this inspection the service was supporting five people with their care and support needs.

A registered manager was in place. A registered manager is a person who is 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.

At the last inspection of the service in September 2014 we found that the service needed to make improvements in relation to how they managed their records. We re-visited the service in November 2014 and saw that improvements had been made as to how the service managed their records.

During this inspection we saw that improvements were needed as to the timings of staff arriving to deliver people’s care and support. This was because people told us on occasions staff were late which impacted on their day.

Improvements were needed to ensure that all staff had the opportunity to discuss their role formally with their manager on a regular basis.

The registered provider spoke to people on a regular basis whilst delivering their care and support; however, there were no formal system was in place for the registered provider to learn from people’s experiences of the service to improve the quality of the care delivered.

Improvements were needed to ensure that all records within the service were maintained appropriately. This would help ensure that important information is available when needed.

Prior to a service commencing, an assessment of a person’s needs was carried out. This process helps ensure that people’s needs were met safely and in a manner they wanted.

Recruitment procedures were in place to help ensure that only people suitable to work with vulnerable people were employed at the service.

Systems were in place to help ensure that people received their medicines safely.

Staff had received training to help ensure that care and support was delivered safely.

People told us that staff were always respectful when they visited and that they always respected their privacy when delivering personal care.

Each person who used the service had a care plan that detailed their care and support needs. Care plans contained specific information about the individual and important information that staff needed to know about when delivering people’s care and support.

We saw that records were stored appropriately. Locked cabinets were available to ensure that people’s personal information was stored securely. Records stored electronically were password protected.

We have made improvement reccommendations in this report to improve the service. We recommend that staff receive regular opportunities to formally discuss their role with their manager; that the service re-introduces their quality auditing system so that people who use the service have the opportunity to give their comment on the care and support they receive.

We have made reccommendations that the service develops and implements a robust system that ensures that people receive care and support at the times they require.  A further recommendation has been made that records are maintained for the required amount of time.

6 November 2014

During an inspection looking at part of the service

This was a follow up inspection, to assess if the non-compliance, which was identified at our inspection in September 2014, had been addressed. We found that people's care record files were disorganised and poorly maintained, with scribbled bits of loose paper, which could have placed people at risk of not receiving appropriate care. At this inspection In November 2014 we found that appropriate action had been taken.

Always Better Care is a Domiciliary Care Agency (DCA). The agency was providing support and care to people living in their own homes. At the time of our inspection, the agency was providing a service to 40 services users in and around the St Helens area.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe?

In September 2014 we saw that people had been cared for in their own homes and the service had checked if this was safe, clean and hygienic. Equipment in people's homes to assist staff was assessed by the service as suitable to meet people's needs.

We saw records which demonstrated that there were sufficient numbers of staff available to meet people's needs.

Is the service effective?

In September 2014 we visited three people in their own homes who told us they were happy with the care that had been provided.Some of the comments were, 'They (care staff) are brilliant, you can talk to them about anything' and 'I am familiar with the carers who come to me, honest to God, they are marvellous'.

We spoke with the manager, the quality monitoring manager and two members of staff and they were able to demonstrate a clear understanding of people's needs and how to meet them.

Is the service caring?

We observed staff supporting people in a positive and caring way during our inspection in September. Staff expressed how they felt enthusiastic about caring for people. Some of the staff comments were, 'Just love the work 'and 'I transferred from another agency, to stay with (name), we get on great'. Comments received from people we visited and completed surveys from earlier this year were, 'I am more than happy with my regular carers, their consideration and respect for me is second to none', 'I feel all of the carers are extremely pleasant and obliging' and 'They (staff) have given me so much confidence'.

Is the service responsive?

In September 2014 we found that the agency assessed people's needs before they were offered a service; this was to make sure they could meet people's individual needs. We saw that peoples care plans had limited information regarding their backgrounds or social history. The manager confirmed that they would review and update people's care files to better reflect a more person centred and individualised care plan. During this visit in November 2014 we found that this had taken place.

The agency had referred people to other services, for example we saw that one person had been referred to the Local Authority for a review of their care needs and another had started attending a day centre, following a referral by the agency.

Is the service well-led?

The service had a manager in place that was registered with CQC. We looked at how the manager made sure that the quality of the service being provided was appropriate.

We saw that there were arrangements in place to help make sure that the quality of the service was monitored. These included an annual questionnaire survey, regular team meetings and the agency had an electric monitoring system in place, which was linked to the local authority's contract monitoring unit. This was to ensure that people were receiving the correct amount of time allocated to them.

Comments from the staff spoken with were, 'The manager is approachable and very supportive' and 'I know I can go to the manager, if I have any concerns'.

10 September 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found.

Always Better Care is a Domiciliary Care Agency (DCA). The agency was providing support and care to people living in their own homes. At the time of our inspection, the agency was providing a service to 40 services users in and around the St Helens area.

Is the service safe?

We saw that people had been cared for in their own homes and the service had checked if this was safe, clean and hygienic. Equipment in people's homes to assist staff was assessed by the service as suitable to meet people's needs. We were told by people who used the service that they felt safe and secure with the care staff. People told us, 'Sometimes they (Care staff) can get delayed, but generally on time and if they are late, they always apologise', 'I wish the carer could stay for 12 hours a day. I love them coming, I hope it never stops' and 'I don't worry about anything now, with (named carer) coming in to me. I feel excellent in myself'.

We saw records which demonstrated that there were sufficient numbers of staff available to meet people's needs.

Is the service effective?

We visited three people in their own homes who told us they were happy with the care that had been provided.

Some of the comments were, 'They (care staff) are brilliant, you can talk to them about anything' and 'I am familiar with the carers who come to me, honest to God, they are marvellous'.

We spoke with the manager, the quality monitoring manager and two members of staff and they were able to demonstrate a clear understanding of people's needs and how to meet them.

Is the service caring?

We observed staff supporting people in a positive and caring way during our inspection. Staff expressed how they felt enthusiastic about caring for people. Some of the staff comments were, 'Just love the work 'and 'I transferred from another agency, to stay with (name), we get on great'. Comments received from people we visited and completed surveys from earlier this year were, 'I am more than happy with my regular carers, their consideration and respect for me is second to none', 'I feel all of the carers are extremely pleasant and obliging' and 'They (staff) have given me so much confidence'.

Is the service responsive?

The agency assessed people's needs before they were offered a service; this was to make sure they could meet people's individual needs. We saw that peoples care plans had limited information regarding their backgrounds or social history. The manager confirmed that they would review and update people's care files to better reflect a more person centred and individualised care plan.

The agency had referred people to other services, for example we saw that one person had been referred to the Local Authority for a review of their care needs and another had started attending a day centre, following a referral by the agency.

Is the service well-led?

The service had a manager in place who was registered with CQC. We looked at how the manager made sure that the quality of the service being provided was appropriate.

We saw that there were arrangements in place to help make sure that the quality of the service was monitored. These included an annual questionnaire survey, regular team meetings and the agency had an electric monitoring system in place, which was linked to the local authority's contract monitoring unit. This was to ensure that people were receiving the correct amount of time allocated to them.

Comments from the staff spoken with were, 'The manager is approachable and very supportive' and 'I know I can go to the manager, if I have any concerns'.

8 August 2013

During a routine inspection

We asked three people for their views on the quality of service they received from the provider. People told us they experienced good care from competent staff. People particularly commented that they knew their carers by name and that they did receive care calls on time and from the same carers. People said this enhanced their care experience. One person told us "I've never had a bad experience."

Three staff we were able to speak with included a carer, a team manager and the manager of the care agency. Staff told us they felt supported in their work. We found the provider was committed to ensuring staff skills and knowledge were updated regularly.

The care agency was relatively small, delivering a number of care and support packages to people in their own homes. The provider had taken steps to ensure people were cared for by regular carers. This demonstrated the provider understood how important it was to people that their carers should be familiar and known to them. One person we talked to about the care they received, referred to their carers as "my girls." Another person told us they knew their carers by name and felt "in good hands" when receiving care.

When we spoke with contract compliance monitoring officers from the local authority, we found that they had no concerns about the care delivered. Recent inspections showed the provider was meeting required standards.

20 July 2012

During a routine inspection

We visited two people who use the service in their own homes to ask them about their experiences of the care they received.

One person was unable to speak with us directly. However, we were able to speak with his wife who said 'the staff are very good' and 'they usually come on time.' She was very happy that the same care workers came regularly because she had confidence in them.

Another person told us, 'I am very happy with my care and I am treated well.' They talked very positively about the care workers and said they always listened to them and treated them with respect. They said if they had any concerns they would 'tell them [care workers] and they would sort it out.'