Archived: Yorkshire Office

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five key 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. The summary describes the records we looked at and what people using the service, their relatives and the staff told us.

Is the service safe -

The manager told us sufficient staff were employed for operational purposes and there was a good skill mix within the staff team. The support workers we spoke with confirmed they had attended an induction programme and received on-going training and support which ensured they had the skills they needed to support the people they cared for. This demonstrated to us the manager did not allow staff to work unsupervised until they felt confident they were competent to carry out their roles safely

The relatives we spoke with told us support workers were professional in their approach to providing care and support and always appeared competent and well trained. We found the support workers we spoke with had a good understanding of people's need and encouraged people to remain as independent as possible within a risk management framework.

The provider had a medication administration policy which outlined procedures for the management and administration of medication. We found the policy was been followed which meant medicines were administered safely.

Is the service effective -

The relatives we spoke with told us they were involved in planning people's care and support and were pleased with the standard of support they received. They also told us the management team were very approachable and they could contact them at any time if they had a problem.

We saw support plans were in place for all people who used the service and they were generated from the initial needs assessment. We saw people who used the service or their relatives had signed their support plans which showed that the plan had been explained to them and they had agreed and understood the content. We looked at four support care plans and found they were person centred and provided support workers with the information they needed to carry out their roles effectively and in people's best interest.

Staff were supported to deliver care safely and to an appropriate standard.

Is the service caring -

The relatives we spoke with told us they were involved in the planning of people's care and support and were pleased with the standard of care they received. They also told us the management team listened to them regarding how they wanted their care and support to be delivered and all the support workers were kind, caring and friendly.

One relative told us "The support workers are excellent, they never let me down and are always pleasant and cheerful."

Is the service responsive -

The relatives of people who used the service told us the initial assessment process was thorough and the manager had listened to them regarding how they wanted their care and support to be delivered. They also told us they were encouraged to ask questions during the initial assessment visit and this had helped them to make an informed decision about whether or not the agency could meet their needs.

One relative told us the agency had a flexible approach to providing care and support and had acted on their request to change their support package at short notice.

Is the service well led -

We saw there was a quality assurance monitoring system in place that was designed to continually monitor and identify shortfalls in the service and any non-compliance with the essential standards of quality and safety.

The relatives of people who used the service told us they had confidence in the management team. They said they were approachable and were in contact with them on a regular basis. One person said "I have the contact details for the management team and have always been able to contact them if I have a problem or concern." Another relative said "Although I have had in the past had some concerns about the service things have improved recently.'

The support workers we spoke with confirmed they were well supported by the management team. They said they could contact them at any time if they had concerns. All the support workers we spoke with told us the communication between management and staff was good. This ensured the needs of people who used the service were met in line with their agreed support plan.

Below is a summary of what we found. The summary is based on our speaking with people using the service and their relatives, the staff supporting them and from looking at records.

The detailed evidence supporting our summary please can be read in our full report.

Is the service safe?

We spoke with one person who used the service and seven relatives. Seven of the eight people we spoke with raised concerns about staffing arrangements because they were not receiving their agreed care package. Voyage Specialist Healthcare Limited did not have enough staff.

The provider had a medication administration policy which outlined procedures for the management and administration of medication. This included staff training, self-medication, administering medication, safe disposal, recording medicines, and monitoring and reviewing. We found the policy was not always followed which meant medicines may not be administered safely.

Is the service effective?

Staff were not always supported to deliver care safely and to an appropriate standard. Six of the 12 members of staff we spoke with told us they had not received enough training or support to do their job well.

In the main, people's needs were assessed and care and support was delivered in line with their care plan. Some care plans contained detailed information about how people's needs including any specialist needs. They identified how care and support should be delivered and what was important to each person. Some care plans were not specific and the guidance on care delivery was not clear. The registered manager had identified that some aspects of the care planning and assessment process could improve and had started to work through these with the management team and people they supported.

Is the service caring?

People told us the standard of care they received was good. People were complimentary about the staff that supported them. One person said, 'The staff who come are very skilled. Communication is also good.' Another person said, 'They are good at care planning.' Another person said, 'The girls are very caring and will sit and chat which is nice.'

People told us staff were respectful and their privacy and dignity was maintained. One person said, 'When the care workers are providing care they are spot on.' Another person said, 'We have a really good rapport.' Another person said, 'They are very, very patient and centred on the care.'

Is the service responsive?

People were made aware of how to raise concerns or make a complaint. We asked for and received a summary of complaints people had made and the provider's response. The evidence we reviewed indicated the provider had considered complaints and responded appropriately.

Is the service well led?

At the inspection we were presented with information that showed action was being taken to address a number of systems that were not working effectively. The provider was supporting the management team to make quality improvements.

We spoke with members of staff, one staff member said”, “Every person has an informed choice, and we discuss their care with them every time we go to see them.”

We spoke with three people who used the service. They told us they were happy with the care provided and were involved with their care and support needs. Everyone we spoke with said their dignity was respected and they were getting the same care worker for each of their visits. People said that their care package was individualised to meet their needs. They also told us that they felt safe with the care worker.

We spoke with three relatives who told us they were happy with the care, they were well looked after and staff understood the care needs of their relative. They said their relative's dignity was respected. The relatives confirmed they would talk to the manager if they had any concerns. They told us their relative felt safe.

Comments from people who used the service included

“The package is about me as a person.”

“They talk through your care package, and it’s tailored to suit me, staff also discuss my care every month and involve me in any changes.”

Comments from relatives included

“They treat my son like a normal person and that makes him feel like a special person."

“Care is really good and I know exactly who's coming and when."