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Smart Care Limited Requires improvement

This service was previously registered at a different address - see old profile

The provider of this service has requested a review of one or more of the ratings.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 February 2019

Care service description

Smart Care is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older and younger people some of whom may be living with dementia or have a learning or physical disability. At the time of our inspection the service provided a regulated activity to 68 people.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good for Safe and Caring but improvements were required in Effective, Responsive and Well Led. The service has now been rated as Requires Improvement overall.

The provider had not put in place robust systems to ensure that they were aware that staff attended calls. Records were not always being maintained to ensure they were accurate and up to date.

Staff were not always receiving appropriate supervision that related to their role. There was insufficient records that staff were signed off as competent to deliver care. There was insufficient guidance in care plans that we reviewed around the support that people required. We have made recommendations around this.

People were safe because staff were aware of the safeguarding procedure. There were sufficient levels of staff on duty to ensure that people’s needs were met. Recruitment was robust to ensure that only appropriate staff were employed.

Risks to people’s care was managed well by staff and people received their medicines in a safe way. The provider had up-to date procedures to help ensure people remained safe should there be an emergency. Staff understood how to reduce the risk of spreading infections.

Assessments of people’s needs were undertaken before they started receiving care. People were supported with their health needs and referrals were made to health care professionals where needed. People were provided with sufficient food and drinks when needed.

People felt that staff were caring, and kind and developed good relationships with them. They felt that staff treated them with dignity and were respectful towards them. People were involved in their care planning and where asked how they wanted their care to be delivered.

People told us that they would speak to staff if they had any concerns. There was a complaints procedure should anyone wish to complain and we saw that these were investigated fully.

The provider carried out other quality assurance checks to ensure people received a good standard of care. Staff consulted with outside professionals to ensure the best delivery of care.

People, relatives and staff felt that the service was well managed. Staff felt supported, valued and listened to.

The registered manager had informed the CQC of significant events including safeguarding and incidents.

Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 8 February 2019

The service was safe.

People told us that they felt safe in their own homes and relatives were confident that people were safe with staff.

Staff received training and were knowledgeable about safeguarding people.

Robust recruitment practices took place before new staff started work.

People were supported with their medicines where appropriate.

Risk assessments had been completed that were clear and provided

staff with the necessary information to help people remain safe. Staff understood how to reduce the risk of infections.

Accident and incidents were appropriately dealt with by staff.

Effective

Good

Updated 8 February 2019

The service was not consistently effective.

Staff had had not always received appropriate supervisions to support them in their role.

Staff received training specific to the needs of people. Assessments of people’s needs took place before they received care.

Staff had a clear understanding of the Mental Capacity Act and

its principles.

People were supported with their healthcare needs, in interacting with medical professionals and in managing appointments. Staff worked well as a team.

People were supported to eat and drink healthily.

Caring

Good

Updated 8 February 2019

The service was caring.

Staff ensured that people and their families were treated with kindness and compassion.

People felt that staff always treated them with dignity and respect.

People were able to express their opinions about the service and were involved in the decisions about their care.

Responsive

Requires improvement

Updated 8 February 2019

The service was not consistently responsive.

Care plans did not always contain detailed guidance around the care that was required. However, staff understood people's care and support and provided the appropriate care.

People knew how to make a complaint and who to complain to. We saw that complaints were responded to in an appropriate way.

Well-led

Requires improvement

Updated 8 February 2019

The service was not always well- led. Improvements were required around ensuring that staff attended calls and how records were maintained.

There were other appropriate systems in place that monitored the safety and quality of the service.

Where people's views were gained these were used to improve the

quality of the service.

People and staff thought the manager was supportive and they

could go to them with any concerns.

The culture of the service was supportive and staff felt valued and included.

Where appropriate notifications were sent to the CQC.