Casa Care Ltd

Casa Care Limited, Leamington Spa, is a domiciliary care agency which is registered to provide personal care and support to people in their own homes. The service offers daytime and night-time care and support. The service is registered to provide support to older and younger people, people living with dementia, people with mental health support needs, people with a learning disability, a physical disability, and people with a sensory impairment.

At the time of our inspection, the service was supporting 53 people. 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.

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

The provider had quality check systems in place to monitor the services provided. However, these had not always been effective.

An IT issue during August 2022 had presented some challenges to the provider and had led to a lack of timeliness with care calls. Prior to our inspection we had received concerns about a missed care call and the timeliness of care calls. At this inspection, lateness of care calls continued to be an area in need of improvement. The provider had, during December 2022, implemented a new care call monitoring system.

The provider’s systems and processes had not identified potential risks to people. Staff were unable to refer to detailed person specific risk management plans. Whilst staff had been trained in generic risk management, they did not have written guidance to refer to about people’s individual or specific health condition and how risks related to those should be managed.

People felt safe with staff. Staff were recruited in a safe way and received an induction and training. However, spot checks that took place to ensure staff had the skills they needed were not consistently effective in relation to new staff.

Some improvement was needed in communication from office staff and managers to people, relatives and care staff. Whilst the provider had a complaints policy and written complaints had been investigated and addressed, where informal issues had been raised not everyone felt these had been fully resolved.

People had plans of care which contained instructions to staff about the tasks they needed to complete. People described care staff as kind and caring toward them. People received their medicines as prescribed and support with meal preparation when this was a part of their agreed care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Model of Care and setting that maximises people’s choice, control and independence

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service did support least restrictive practices.

Right Care: Care was person-centred and did promote people’s dignity, privacy and human rights

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff did ensure people using services led confident, inclusive and empowered lives.

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 July 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. This included some concerns shared with us about people not receiving care at the required time or for right duration of time. We decided to inspect and examine those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can read the report from our last inspection by selecting the 'all reports' link for the Casa Care on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People's experience of using this service:

¿People felt safe using the service and staff understood how to protect people from abuse and keep people safe.

¿Risks associated with people's care were assessed and staff were informed how to manage and reduce risks through care plans and the electronic call planning system. Some risk management plans required more detail, and this was addressed by the registered manager.

¿Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

¿Staff had access to the support, supervision and training they required to work effectively in their roles.

¿When staff had concerns about people’s health or wellbeing, they ensured people received the medical care they required.

¿The provider had safe protocols for the administration and recording of medicines.

¿People were supported to have maximum choice and control of their lives and staff gained people’s consent before providing them with personal care.

¿Staff told us they enjoyed working for the service because they enjoyed caring for people. People spoke positively about the standard of care they received from staff who respected their privacy and dignity.

¿There were systems in place to monitor, maintain and improve the quality and safety of service provided.

¿The management team and staff worked in partnership with other professionals to improve outcomes for people. They had recently worked collaboratively with other agencies to ensure a safe transfer of 39 care packages from another local provider to minimise disruption to the care people received.

Rating at last inspection: Good. (The last report was published on 22 August 2016).

Why we inspected: This was a planned inspection to confirm that the service remained Good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

There was a registered manager in post. 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.

The service is provided for adults who may live with learning disabilities, autistic spectrum disorder, mental health, a physical disability or sensory impairment. At the time of our inspection, 110 people were receiving the service.

People were safe and were protected from the risks of abuse. Staff were trained in safeguarding and understood the action they should take if they had any concerns that people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.

Care plans included risk assessments for people’s individual health and wellbeing and described the actions staff needed to take to minimise the identified risks. Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff when they started working for the service.

The registered manager assessed risks in each person’s home and advised staff of the actions they should take to minimise the risks. People’s medicines were administered safely because the provider’s medicines administration policy included training staff and checking that people received their medicines as prescribed.

Staff received training and support that enabled them to meet people’s needs effectively. Staff had opportunities to reflect on their practice and consider their personal career development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Records showed that people, their families and other health professionals were involved in making decisions about their care and support. Staff understood they could only care for and support people who consented to being cared for.

Staff referred people to healthcare professionals for advice and support when their health needs changed, and supported people to follow the health professionals’ advice.

People told us their care staff were kind and understood them well, so they felt like friends. The provider asked people about their preferences, likes and dislikes for care and support during their initial assessment of needs.

People told us staff respected their privacy, dignity and independence, and they were supported to live the lives they wanted. People knew any concerns or complaints would be listened to and action taken to resolve any issues.

People were encouraged to share their opinions about the quality of the service through surveys and one-to-one conversations with a member of the management team.

The staff and management team shared common values about the aims and objectives of the service. People were supported and encouraged to live as independently as possible, according to their needs and abilities.

The provider’s quality monitoring system included regular checks of people’s care plans and staff’s practice. When issues were identified the provider took action to improve the quality of the service people received.

People and their representatives told us they were involved in their care and treatment decisions. Some people told us they were not given the option of what time they could have their care call. They said they were happy with the care provided.

We saw care plans for three people who received a service from Casa Care. The care plans contained important information about people, for example people's next of kin details. People told us that sometimes their care call was late.

Comments from people and their family members included, 'They (care workers) are respectful, they have the right attitude. The care is personalised to X very much' and 'I am quite happy with them (Casa Care).'

The service had systems in place for recruitment of care staff and we saw checks had been undertaken to ensure staff were suitable to look after people safely.

We found the service had good systems in place to monitor the quality of service provided and was well led.