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Continued Care from Oakville Ltd Good

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


Inspection carried out on 29 October 2018

During a routine inspection

This inspection took place on 29 October, 2 and 7 November 2018 and was announced. At our last inspection in November 2015 we found the service was good. At this inspection we found the service remained good.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and children. There were 38 people using the service at the time of the inspection.

Not everyone using Continued Care from Oakville Limited receives regulated activity; the Care Quality Commission only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. A registered manager is a person who has registered with CQC 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 was led by a registered manager who was an excellent role model to staff and who had received accreditation and recognition for maintaining and demonstrating innovative practice and quality care delivery. The registered manager had been asked to contribute to a parliamentary review for adult social care, which is a document that showcases examples of sector-leading practice, and had won a national award recognising high standards of practice.

Staff were empowered to contribute positively to the development of the service. Their ideas were listened to and where they could benefit people and the quality of care they were implemented. These ranged from staff incentives to Zumba classes for people and their relatives to improve their mobility and social activities.

Care plans were written in partnership with people according to their aims and personal goals, and included high quality and detailed information on people’s preferences and how they wanted their needs to be met. The service used technology creatively to ensure they received up to date information on changes to people’s needs, and people could also communicate directly with the service’s electronic systems to ensure any key messages were instantly taken on board.

People were positive about staff attitude and care, and we saw examples where staff had gone ‘above and beyond’ their roles to make meaningful improvements to people’s lives. The service provided its own staff to ensure a day centre, ran by a charity for people living with dementia, could run safely and their engagement was vital in the maintenance of this service which allowed people to participate in their community and provide respite for their relatives.

People’s feedback was sought in creative and innovative ways and used to improve aspects of the service. For example, improvements to the interview process for staff took into account suggestions made by a person using the service. The service donated to charity for every survey response received.

There were enough staff to meet people’s needs. The service monitored staff electronically to ensure punctuality. Rotas were flexible and could be changed to ensure everyone’s needs were met. Staff were recruited safely.

Medicines were managed safely. Medicines administration records were audited regularly. Staff received training in medicines safety and had their competency assessed by senior staff before administering medicines on their own. Risks to people were assessed appropriately and contained detailed information. Staff received training in safeguarding adults and were able to describe how they would protect people from harm.

People told us staff were trained and competent to meet their needs. Staff received a comprehensive induction and training programme. Staff told us they felt we

Inspection carried out on 25 November 2015

During a routine inspection

We undertook this announced inspection on the 25 November 2015. At the previous inspection, which took place on 4 September 2013 the service met all of the regulations that we assessed.

Continued Care from Oakville Ltd is registered to provide personal care to people who live in their own home. The service supports people who live in the Settle, Bentham, Long Preston and surrounding villages. The agency office is in the centre of Settle. There is parking available nearby, in a ‘pay and display’ car park. Visits vary in duration and support is offered for such things as personal care, twenty four hour care, end of life care, companionship, domestic tasks and escorting to medical appointments. At the time of this inspection the agency was providing support for 60 people. The agency employs 20 care staff and a registered manager.

There was a registered manager at this service. 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 told us they felt safe and trusted the care staff who came into their home to support them. They described staff as ‘excellent, trustworthy and considerate’ Staff were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary. Staff also told us that the registered manager listened and acted on their feedback. The safeguarding policy was up to date. Appropriate risk assessments were in place to reduce the risk of harm. These were kept under close review and the staff approach was very flexible to allow for changes in circumstances.

The service recruited staff in a safe way making sure all necessary background checks had been carried out. Care workers were organised and deployed in a way that met people’s individual care needs, with small individual teams of staff who knew people well. People who used the service and their relatives told us that they received an individual, consistent and reliable service.

The service had health and safety related procedures, including emergency plans, in place. Staff had regular contact with other healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing. We saw staff had been pro-active where people required medical attention and they were provided with care and support according to their assessed need.

Systems were in place for reporting and recording accidents and incidents, including detailed reviews and actions, were in place. The care records we looked at included individual risk assessments, which had been completed to identify any risks associated with delivering the person’s care. Where people’s needs were complex relevant professionals had been involved to provide advice and training. People gave good examples where staff had acted quickly in accessing medical assistance for them when needed. This meant staff acted quickly and appropriately to ensure their health care needs were met. Records also showed that risks were managed positively, so that people were supported to develop confidence, skills and independence.

Care plans were comprehensive and detailed to ensure people’s care needs were met by staff from the service. Some of the people who used the service were supported with taking their prescribed medication and staff were trained and competent to assist people with this. People we spoke with confirmed that they received good support from staff with their medicines and that they always got them or were reminded to take them.

People’s care records showed that their needs had been assessed and planned in a very detailed and person centred way. People who used the service and their relatives told us that they were involved in planning and reviewing their service and that their views were listened to. We saw clear examples where staff had supported people to take positive risks and develop their independence. People we spoke with told us that staff from the service obtained their consent and treated them in a dignified way and always respected their wishes.

We saw exceptional examples of where staff had gone the ‘extra mile’ ensuring people they supported not only received good quality care, but also maintained their various interests. One example being a person’s interest in cars was rekindled. Another example was where one person was supported to access the community they lived in. This meant that people became less socially isolated and enabled them to live their own lives within their own home. This had a positive impact on people’s well-being.

People and their relatives told us that staff were caring, treated them well and respected their privacy. Staff were able to describe how they worked to maintain people’s privacy and dignity. We saw clear examples of people being supported to develop their independence.

Staff had been provided with training and support to help them carry out their role. This included specialist training and support from relevant health care professionals where someone had complex needs. People who used this service and their relatives told us that staff were competent and knew what was expected of them. Staff told us they were well supported by the registered manager and other managers, who had clear expectations and provided regular support. We saw evidence of staff being encouraged to develop their own professional expertise and there was a strong focus on professional development.

The service supported people in their own homes and provided help with meal preparation, eating and drinking where this had been agreed as part of the person’s care package. If people needed support with eating and drinking this was detailed in their care plan and professional advice had been sought if people had complex nutritional needs.

People had been provided with a handbook about the service, which included the formal complaints process. People also told us that they were given opportunities to raise issues or concerns on an on-going basis. We saw complaints that had been made since the last inspection had been thoroughly investigated and responded to by the service. There were many compliments and letters of thanks.

People who used the service were extremely positive in their comments about the running of the service and the staff. They told us that this was an ‘excellent service’ with people being ‘100 % satisfied.’

The service was well-led. The registered manager was very well qualified and experienced. The management team were committed to providing a good quality service. People who used the service and their relatives all told us the service was very well led, with an ethos of providing high quality, person centred care. Staff were passionate about providing high quality services that focused on the individual.

The service had introduced and had implemented the role of ‘staff champions’ in areas such as dementia, medicines, safeguarding people, dignity and respect and disabilities in all of their care teams working for the organisation.

Systems and processes were in place to monitor the service and make improvements where they could. People who used the service, relatives and other professionals were routinely involved in meetings, reviews and on-going work so that their feedback could be taken into account.

There were excellent auditing and monitoring systems in place to identify where improvements were required and the service had an action plan to address these. Policies and procedures had been updated to ensure they were in line with current legislation.

The service had exceptional systems in place for people who used the service or their relatives to communicate with them. For example a ‘web portal’ had been introduced. This could be accessed remotely from people's own home or their relatives home. This allowed people to access and view the care schedules and see who was attending the visit and to book and amend visits and send messages directly to the rota coordinators. The service also arranged ‘service user forums’ although this had been declined in Settle. This gave people who used this service the opportunity to meet with other people who also received a service from Continued Care. The service also arranged each year a Christmas Party for people who used the service. This had also been declined by people in Settle.

The leadership team had an appetite to continually improve the service; one example of this was their focus on work to develop ‘service user champion roles.’ This would give people who used the service opportunity to discuss their ‘user experience’ at the ‘service user forums.’

The organisation continued to be audited both internally and externally to check and set benchmarks to ensure the services practice, quality and standards of care were continually maintained to a high standard. The service had sustained outstanding practice and improvements over time as they held the Investors in People – Gold. The service is also an ISO 9001-2008 accredited organisation. This is recognition in good practice that the service had continuously held which was audited by external auditors, who verify and benchmark practice.

Inspection carried out on 4 September 2013

During a routine inspection

We spoke with six people who used the service, by telephone on the day after the visit to the agency. Everyone we spoke with told us they were completely satisfied with the care and support they received from the agency. People told us that staff were �kind, patient, considerate and polite.� They said they were treated extremely well by the care workers. One person told us, "I have got to know my carers really well, they are always on time and stay for the time I am paying them for.� Everyone told us that if they had a complaint they would contact the manager, who they knew them by name, and they were confident that any problems would be dealt with effectively and in a timely way.

We looked at nine people�s care records. We found records were accurate, up to date and regularly reviewed. We saw records that showed people who used the service and their relatives, were involved in developing their care plans. People we spoke with said they understood their care plans and that staff had explained things to them in detail.

We looked at some staff records and spoke with seven members of staff, face to face, during our visit to the agency office. They all told us they were well trained and supported in their work. Staff spoke positively about their roles and said they were proud of the quality of care they provided. One member of staff told us that because Settle is a small town, people knew one another and often people they had grown up with were now people they were supporting. This they thought helped to establish a trusting relationship and that the reputation of the agency was reliant on the quality of the care staff delivered.

The staff we spoke with told us they knew what to do if they suspected abuse and were able to give examples of when they would escalate information given to them. This meant that any concerns would be reported promptly and dealt with properly.

The agency had systems in place to make sure people were safely cared for. This included policies and procedures, training for staff and quality monitoring systems.