Dales Community Care Limited

Dales Community Care Limited is a domiciliary care agency and provides personal care to people in their own homes. The office is based in the village of Grassington in the Yorkshire Dales and supports people in the local and surrounding areas. At the time of this inspection the service was providing care and support to 68 people.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We have made a recommendation regarding the identification and management of risk.

Medicines were managed safely and staff competencies were checked to ensure practice remained safe. The service continued to recruit people appropriately and employed enough, competent staff to care for people. Staff were provided with the right equipment and training to limit the risk of the spread of infection. People who used the service were kept safe from abuse and improper treatment.

People were empowered to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Staff training was up to date and included a range of specialist courses including, end of life care, pressure sore awareness and dementia care. Staff were appropriately supervised and their performance appraised annually. People gave positive feedback about the support they received to maintain a balanced diet and staff communicated effectively with other health care professionals about people’s changing needs.

People received kind and compassionate support and were treated with dignity and respect. People were encouraged to maintain their independence and staff cared for people in a way that protected their dignity and privacy.

Care plans contained person-centred information and provided staff with clear guidance to care for people in a way they preferred.

The registered manager actively sought the views of people who used the service and any concerns raised were addressed in a timely way and to people’s satisfaction.

The registered manager continued to play an active role in the running of the service and undertook quality checks and monitoring to ensure the delivery of high-quality care. The registered manager reviewed incident and accidents and discussed lessons learnt at staff meetings.

Further information is in the detailed findings below.

Dales Community Care Limited is a domiciliary care agency, providing personal care to people in their own homes. The office is based in the village of Grassington in the Yorkshire Dales and supports people in the local and surrounding areas.

At the time of this inspection the service was providing support for 61 people. The Dales Community Care Domiciliary Care Agency employed 24 support staff and also a registered manager.

The registered provider is also the registered manager. They had been registered with us since February 2013. A registered manager is a person who has 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.

People who used the service and relatives told us that the service was safe. People were protected by staff who were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary.

The service recruited staff in a safe way making sure all necessary background checks had been carried out. There were risk assessments in place to identify risks due to people’s health or mobility and to make sure these were minimised without intruding on people’s privacy and independence. There were records that showed staff received the training they needed to keep people safe.

Care plans were comprehensive and had associated risk assessments. Some of the people who used the service were supported with taking their prescribed medication and staff told us they were trained and competent to assist people with this.

People were protected because staff at the agency were aware of and followed the principles of the Mental Capacity Act 2005.

Staff were supported and trained to help them deliver effective care. They had access to mandatory training, and staff told us they were supported to attend other courses which would be of benefit to their personal development and people who used the service.

Staff had regular contact with other healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing. People were provided with care and support according to their assessed need.

Systems and processes were in place to monitor the service and make improvements where they could. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages. Policies and procedures had been updated to ensure they were in line with current legislation.

The service was well-led. The management team were committed to providing a good quality service. Systems and processes were in place to monitor the service and make improvements where they could. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages.

There were good auditing and monitoring systems in place to identify where improvements were required and the service had an action plan to address these.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary please read our full report.

This is a summary of what we found:

Is the service safe?

People spoke positively about the care they received and about their care workers. People said they knew who to speak to if they had any worries or concerns and were confident that action would be taken if they raised any issues. One person said 'I feel safe when they (carers) visit and not at all vulnerable. And if I did have a complaint I would speak to X in the office who would resolve it.' Another person said 'They (carers) are all brilliant. X will do anything for me and X is very kind and caring and I am very comfortable with her.'

People told us that they felt their rights and dignity were always respected.

Effective management systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints, concerns and investigations. The service had completed comprehensive risk assessments for the environment and people's physical and mental health.

People we spoke with confirmed they received their medication as prescribed. Some people told us that they could administer their own medication safely with minimal support from staff.

Procedures were in place for dealing with emergencies and staff were able to explain these to us.

Is the service effective?

People's files contained pre-admission assessments, which showed that people's health, personal and social care needs were assessed before care was delivered to them at home.

When people were identified as being at risk, their care plans showed the actions required to manage these risks. These included the provision of specialist equipment such as pressure relieving mattresses, hoists and walking aids.

People we spoke with confirmed they had a care plan in their home, which was followed by carers when they visited. People said that their care plans were up to date and reflected their current needs. Records we saw supported this. One person said 'They (carers) are all very pleasant and they do the job their supposed to do and you always feel comfortable with them when they are in your home.'

Staff had received training to meet the needs of people they support in the community. They had also completed mandatory training so that they could work safely with people. Staff we spoke with told us they received good support from the agency and described the agency as a 'family run company.'

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service caring?

People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. We spoke with ten people who were using the service and three relatives who had relatives using the service. We also checked some of the feedback people had provided. Everyone told us they were satisfied with the care they received and spoke positively about individual care workers. People described carers as being 'caring, cheerful, helpful and efficient.'

Is the service responsive?

People told us their care workers generally arrived on time and they stayed for the correct length of time that had been agreed. People told us if they had any problems they contacted the senior team leader or the manager who would make sure any issues were sorted out. People said whenever possible they were kept informed about any changes to the usual care workers who attended to them.

People we spoke with told us they knew how to make a complaint if they were unhappy. Everyone we spoke with told us they would ring the agency office. People also told us that complaints would be investigated and action taken as necessary. One person said 'I would ring the office and X would sort it out. I know they would.'

Is the service well-led?

We saw that there was an effective and robust quality assurance system in place which meant that the service was learning from any audits and that there was continuous improvements at the service.

Effective management systems were in place to promote and safeguard people's safety and welfare.

Relatives we spoke with told us they thought the service ran well. One relative said 'Overall, It is a very good service.'

We saw from care files that the service worked well with other health care professionals and services to make sure people received the care they needed in a joined up way.

People who used the service told us they were happy and satisfied with the care and support being provided. They made comments like, "The staff are very efficient.' And 'I would certainly recommend this agency to my family and friends.'

People also told us staff supported them as they wished to be supported and were always polite and respectful in the way they cared for them. They also felt that the staff respected their privacy and protected their dignity.

We looked at people's care records. We found that records were consistent, accurate and up to date. We also saw that the service delivered the care in a person centred way which meant that they included people in decision making throughout their care.

We spoke with staff who explained that they had the right training and were well supported by the agency. They also said they were consistently supported by the management team to do their job.

This was the first inspection of the agency. We saw that they had worked hard to put everything in place to make sure that people were safely cared for. This included policies and procedures, induction training for staff and quality monitoring systems.