Archived: Crocus Community Care

Crocus Community Care is a domiciliary care agency providing personal care to people in their own homes. 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. At the time of inspection, the service was supporting a total of 25 people, with 10 people receiving support with personal care.

People’s experience of using this service and what we found

Care plans and risk assessments were in place setting out people’s support needs, but some required a review to ensure they were up to date. Supervisions and spot checks took place informally to ensure staff were supported and competent in their roles

We have made a recommendation about the recording of the level of medicines support required in care plans and a recommendation about medicine competency assessments.

Infection prevention and control (IPC) measures were effective, including the safe management of COVID-19. Whilst there had been no new staff recruited since the last inspection, care was provided by a small, long-standing staff team who knew people well. Lessons were learned from accidents and incidents to reduce the risk of reoccurrence. Staff were confident in how to raise safeguarding concerns.

Assessments were carried out on people’s care and support needs, involving people and their families in the care planning process. Staff had access to online training to develop their skills and knowledge, although some practical training had been impacted by the COVID-19 pandemic. People were supported with food and drink, and staff knew their preferences and choices. The service enabled people to access healthcare support, such as district nurses, GPs and other professionals.

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.

Staff were described as caring, compassionate and kind. People told us they often went ‘over and above’ to make them feel comfortable and cared for. People’s privacy and dignity were upheld, and their independence promoted.

The service was described by people as being responsive, with extra visits and support often available if required in response to people’s changing needs. Communication methods had been considered for people if additional support was required to make information accessible. Staff built rapport with people to reduce the risk of social isolation. Where complaints had been received, this had been followed up openly by the manager and advice sought from external agencies such as the local authority where required. A policy and procedure was in place in case staff needed guidance on supporting people receiving end of life care.

There was a positive and inclusive culture at the service. Oversight and governance systems were in place, including audits, for the purposes of quality assurance. The provider was open and transparent and understood regulatory requirements and the duty of candour. We received feedback the service worked well with other professionals to secure good outcomes for people.

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 6 November 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated good and outstanding to test the reliability of our new monitoring approach.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Crocus Community Care is a domiciliary care service providing personal care to people in their own homes. 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. At the time of the inspection the service was supporting a total of 27 people. 11 people received support with personal care.

People’s experience of using this service and what we found

People told us they felt safe with all the staff who supported them. They continued to receive care from a consistent staff team. There were enough staff to meet the needs of people.

Not all staff had been recruited in line with the provider’s policy as not all pre-recruitment checks had been carried out. Our findings can be seen in the 'safe' section of this report.

We have recommended the provider thoroughly reviews its recruitment processes to ensure they are compliant with legislation and best practice.

People told us staff supported them to receive their medicines as prescribed. We found conflicting information within some care plans as to the level of support people needed with the administration of their medicines. In response to our feedback the registered manager assured us a review of care plans would be carried out and this would be rectified immediately.

Staff had completed safeguarding training and understood their responsibilities to report any concerns to protect people from harm and abuse. Risks to people’s health, welfare and safety had been assessed and guidance provided for staff to keep people safe.

There was a system for staff to report and record accidents and Incidents. However, there

was no system in place to analyse trends and identify high risk areas. Following our feedback, the registered manager put in place a system to ensure the monitoring incidents with action plans to reduce the risk of harm to people.

People told us staff were kind and caring and treated them with respect and dignity. People's independence was promoted and encouraged by staff.

People knew how to raise a complaint and felt confident any concerns would be addressed. People were encouraged to express their views on the service they received and to support continuous improvement.

The culture of the service was person-centred, and staff were committed to providing good quality care. The registered manager had a clear understanding of their responsibilities to meet regulatory requirements.

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.

Rating at the last inspection

The last rating for this service was Good (published 14 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

The service demonstrated they were 'Service user focused' and had systems and processes in place to monitor and improve the service to achieve a consistently high standard of care and support for everyone who used the service. There was a call monitoring system in place and spot checks were carried which ensured visits to people were provided at the agreed times.

People told us they received care and support that met their individual needs. People were involved in the development, planning and review of their care.

Staff knew people well and treated them with dignity and respect. Care plans were personalised and contained detailed information about people’s support needs and risk assessments were detailed and specific providing staff with all relevant information to ensure risks were both identified and mitigated where possible. Staff knew how to recognise and respond to any allegations of abuse. Medicines were managed safely.

People were supported by sufficient numbers of staff that were recruited through a robust process which helped ensure staff were suited for the roles they performed. Staff were inducted and received on-going training and support. Staff had individual supervisions, team meetings and regular contact with office staff to share good practice and discuss any concerns.

People were supported to make their own decisions, and to retain where possible everyday living skills and abilities and their choices were respected. Their views were obtained through a variety of communication feedback methods and people’s views were taken into account.

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care and people were encouraged to be as independent as possible. One relative told us, '[The care workers] don't just do things for my [relative], they let and encourage [them] to do the things [they] used to do like changing the bed.' Everyone we spoke with told us the agency staff treated people with dignity and respect.

Care was planned and delivered in a way that ensured people's safety and welfare. People told us that the care they received from this service met their needs. One person's relative told us the staff were, 'very understanding' of the behaviour of their person who was living with dementia.

The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

During our inspection on we found there were effective recruitment and selection practices in place. This meant people were cared for by suitably qualified, skilled and experienced staff.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others and to assess and monitor the quality of service that people receive.