Archived: Out of Hours Team

The Out of Hours team is registered with the Care Quality Commission as a domiciliary care agency providing personal care and support to people in their own homes in the upper valley, central and lower valley areas of Calderdale. The team’s office base is situated near Halifax town centre. At the time of our inspection the Out of Hours team was supporting 33 people to retain their independence and continue living in their own home.

The service should have a registered manager in position. 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 registered manager had recently left the service and a new manager had been employed who had applied to be registered with the Care Quality Commission.

Appropriate systems were in place to protect people from risk of harm although some risk assessments required updating. People who used the service told us they felt safe with the care they received.

Policies and procedures were in place regarding the Mental Capacity Act 2005 (MCA) which helped to make sure people’s rights were protected.

People were provided with care and support by staff who had the appropriate knowledge and training to safely and effectively meet their needs. We saw the skill mix and staffing arrangements were sufficient for the current needs of the service.

People told us they generally saw the same staff members and care and support was provided without staff rushing.

Safe and robust recruitment processes were in place. Checks to show staff were safe to work with vulnerable adults were undertaken prior to staff working at the service.

Staff received induction and training relevant to their role and were offered opportunities for on-going development. Regular supervisions, appraisals and spot checks had not taken place. The new manager was introducing a system to ensure these took place in future.

Staff turnover was low and people were generally supported by regular staff. Staff were able to tell us about people who used the service, their care and support needs and how they treated people with dignity and respect. People we spoke with told us staff were considerate, caring and respected their dignity and privacy. People said they received a good standard of care and support.

We saw care and support was delivered in line with people's care plans and people were consulted about the care and support required. The manager had recently reviewed care records and saw these needed to be more detailed with more information about people's likes, dislikes and preferences.

Policies and procedures relating to the safe administration of medicines were in place. However, the recording of medicines was not robust.

People were supported to access a range of healthcare professionals. We saw evidence people's healthcare needs were met.

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Staff were not currently supporting anyone with specific nutritional needs due to the nature of the service but ensured people were offered drinks to support hydration needs.

A complaints procedure was in place which enabled people to raise any concerns or complaints about the care or support they received. However, some people told us they felt concerns they had raised were not dealt with. The manager was implementing a more robust procedure to ensure all complaints were documented, analysed and appropriate actions taken.

People using the service, relatives and staff we spoke with were positive about the management team. Staff said they felt supported and the management team were approachable. Staff turnover was low.

The manager recognised there was a lack of quality assurance monitoring systems in place to monitor and identify any shortfalls in service provision and was taking steps to improve this. The service had received a lack of provider governance, support and oversight.

The new management team had planned monthly staff meetings throughout the year although we saw and staff told us these had not been held regularly before they commenced in post.

You can see what action we told the provider to take at the back of the full version of the report.

On the day of our inspection we visited the main office, where we spoke with the team manager and team leader. The manager explained that the service had been started five years ago and the team leader told us they had been in post for about a year. Following our inspection we also spoke with two people using the service, one relative of a person using the service and three of the twelve night support workers.

The two people using the service we spoke with told us they were very happy with the care provided. One person said, 'I have no complaints whatsoever; I'm getting a really good service. I've been using them for 16 years.' The second person told us, 'The ladies that come are very nice and good at what they do. I'm fine with the four ladies I've got coming now.'

The relative we spoke with told us, 'We're highly delighted with the service and my mum's happy with it as well. Everything's going fine; no concerns.'

The three night support workers confirmed what the people using the service had told us; they all felt people received good care from the service. One staff member told us, 'It's an excellent service' and the other said 'It's a very worthwhile service; I don't think there's anything to beat it.' The third said, 'I genuinely think it's a really good service, I'm not just saying that because I work there. It keeps people in their own homes, that's what I would want if I were them.'

Staff received appropriate training for their role and understood the importance of reporting suspected abuse. Staff told us they felt well-supported by their team leader.

During our visit we looked at five people's care records and saw that their individual needs were assessed before they started using the service and care and support was developed from an assessment of their needs.

We found there were enough qualified, skilled and experienced staff to meet people's needs. People using the service were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were being maintained.