Archived: Cosy Care

During this inspection we looked at documentation such as care plans, visit schedules, policies and procedures, training records, staff recruitment records and surveys from service users. We spoke with the manager and one member of the care staff.

This is a summary of what we found '

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?

We found people had an initial assessment of their needs, a care plan and risk assessments in place. Records contained information about people's health and social care needs and daily notes showing how the care and support was delivered. Since our previous inspection, the service had sent out questionnaire surveys to people who used the service. Some of the comments were, 'They (staff) are very good' and 'Their kindness and capability helps me a lot'.

There was an out of hours on call system in place to deal with any unforeseeable issue or emergency. The on call system was operated by a senior carer or the manager of the service. This ensured care and support would be provided to people who use the service, for example, when a care worker was absent at short notice.

People's records were securely maintained in the agency's office. The manager was able to locate all requested documents at the inspection.

Is the service effective?

The records we checked, demonstrated that people's care and support was personalised, with appropriate and relevant guidance for care staff, to assist them to meet people's individual needs.

Records contained information about people's health and social care needs and daily notes showing how the care and support was delivered.

Is the service caring?

Some comments from people who used the service were, 'Everything is fine, thank you to all' and 'I have found all of the staff that I have met, treat me with a caring attitude'.

One staff member said, 'We become more like family members. I love the job' and 'I find it very rewarding and satisfying'.

Is the service responsive?

The service had responded to the need for more up to date training, with varied relevant training being provided since our previous inspection. The service had also improved their recruitment process. These improvements helped to ensure that people's assessed needs were appropriately provided.

Is the service well led?

The service was well led. Cosy Care had a manager who was in the process of applying to be the registered manager with the Care Quality Commission. The manager gave us an assurance that this would be dealt with, without delay. We will monitor the application process.

We saw that the supervision of staff had been taking place and spot checks on care workers had been carried out. These spot checks recorded if care workers had the correct uniform, identification and were carrying protective gloves and aprons. The spot check also recorded the conduct of the care worker and if they had treated the person with respect and dignity.

' 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.

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 using the service that the staff arrived on time and stayed for the correct amount of time. They told us that staff were 'Always on time and phone if they are going to be late, which is very rare'. We also saw records which showed that a member of the management team was on call and available in case of emergencies.

Staff recruitment records did not contain all the information required by the Health and Social Care Act 2008. This meant the provider could not demonstrate that the staff employed to work for the service were suitable and had the skills and experience needed to support people in their own homes. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service effective?

We visited two people in their own homes who told us they were happy with the care that had been provided. One person told us 'I don't know what I would do without them'. Three members of staff we spoke with demonstrated that they had a clear understanding of people's needs and how to meet them.

Staff training was not consistent and some staff training was not up to date. Supervision of staff in order to make sure that they developed and maintain their skills was not consistently done. This meant the provider could not demonstrate that the staff employed to work for the service had the training and support to meet people's needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service caring?

During our inspection we observed that staff were attentive, caring and enthusiastic about providing the needs of people who received a service.

People we spoke with told us that the staff were 'Excellent', 'Can't fault them' and 'They are all angels'.

Is the service responsive?

People's needs had been assessed before they received a service. Records were not always consistent, as an example one person's care plan was detailed and included relevant information about them. This standard was not maintained in the other care plans we observed. The provider confirmed that people's preferences, interests and diverse needs would be included in peoples' care plans in the future.

Is the service well-led?

The registered manager left the role in February 2014, however CQC had not been informed of this, as a result there was no overview and clear management in place for the service. The provider has undertaken to manage the service, however was unable to provide us with much of the information we requested. For example training was out of date, policies and procedures were either unavailable or out of date and the quality monitoring of the service was not consistent.

We saw that a customer satisfaction survey was available however the results of this had not been reviewed and changes made to the service if needed. The provider told us that in future she will make arrangements for people to comment as opposed to a tick box approach.

This meant the provider could not fully demonstrate that the quality of the service and management arrangements were sufficient to meet people's needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We looked at the care files of three people and visited two people in their own homes. Prior permission was obtained before the visits.

We spoke with one of the care staff employed by the care agency. During the home visits we looked at peoples' care files and spoke with the people receiving a service, in order to gain their views about the quality of the service provided.

The people we spoke with said care staff had always treated them with dignity and respect. Some comments from people receiving a service included, "The girls are marvellous. Can't fault them at all,' 'They are the very best,' 'No complaints whatsoever. They (staff) are lovely, not met a bad one yet' and 'They (staff) sit and talk with me, they are brilliant'.