Archived: Custom Care (Stoke)

Below is a summary of our finding based on our observations, speaking to people who used the service, relatives, staff supporting them and from looking at records. We considered our inspection findings to answer the questions we always ask:-

Is it safe?

People's needs were assessed and care plans devised to ensure staff had the information they needed to deliver care.

Medication was managed appropriately and further plans were in place for staff training.

Is it effective?

People all had an individual care plan which set out their care needs. People told us they had been involved in the assessment of their health and care needs and had contributed to developing their care plan. Assessments included the need for any equipment, mobility aids and any risks associated with the delivery of care. This meant that people were sure that their individual care needs and wishes were known and planned for.

Changes to how staff were supported and supervised meant that they were receiving regular contact from the office staff and their care practice was being monitored to ensure people received the support they required.

Is it caring?

One person we spoke with said: "This is the best agency I have used". Another person said: "Everything we require is carried out". Other people were concerned that they did not always receive care at the times they had agreed. Other people commented: "They are often late or don't stay for the time they should" and "They give me the impression they don't always have time to do things properly". A relative said, 'I visit my relative regularly and the staff are lovely to my relative' and another said: "We are changing the agency because they don't always do things as we'd like them to be done".

Is it responsive?

People knew how to make a complaint if they were unhappy. Most people said that they had the contact numbers of the office and felt able to address any concerns they may have. One person said: "I have made complaints in the past, but I think there has been an improvement recently" another said: "I haven't always been confident when complaining but the manager does try to sort things out". One person who used the service told us they had experienced care that fell short of their expected standard, but when they reported the issue it had been dealt with to their satisfaction. They told us: 'This issue has now been sorted out'. We saw complaints were recorded and responded to within the timescales set out in the procedure.

Is It well led?

The home had a system to assure the quality service they provided. Action had been taken to make improvements to the service since our last inspection.

People's personal care records were accurate and complete.

Staff received their rosters on a weekly basis. The provider recognised staff excellence by holding 'care worker' of the month awards. The criteria for the award, included good attendance, positive comments at quality spot checks of appearance, quality of record keeping and from positive feedback from people who used the service.

Changes had been made to strengthen the management team since our last inspection, to ensure there were a sufficient number of coordinators to organise people's care. In addition more senior carers meant that improvements had been made to the quality monitoring frequency, supervision of staff and spot checks.

At the last inspection in July 2013, the service did not have a manager in post who was registered with us. They had contacted us to inform us that a new manager had been recruited, but at the time of this inspection we had not received an application for them to register. The provider is required to have a suitable registered manager in post to manage the service. We have written to the provider separately about this.

During and following our inspection of records in the agency office. We spoke with seven staff. An expert by experience spoke with 14 people who used the service. Comments included "They have bent over backwards to please me and support me since X died. Can't fault them at all or praise them enough, everything is 'Tickety-boo'" and, "As far as I am concerned they are good at it all"

During this inspection we found some improvements in all areas where concerns had been identified previously. Further action to embed these improvements would ensure people's confidence in the service delivery.

Prior to the inspection, we received notification that the registered manager had left the service and was no longer registered with us. According to our records we had not been informed by the provider of the alternative management arrangements that were made in response to the registered manager leaving. We wrote to the provider on 25 July 2013 for this information, at the time of writing this report we had not received a response. This meant that the provider failed to inform us and we could not be assured that suitable arrangements were in place.

We had been told prior to our inspection that there were concerns about some aspects of the service provided to people. We had been told that some people did not receive a visit and that some people had visits that that did not last as long as they should have. We spoke with people who used the service, who told us that calls were late and some calls had been missed. This meant that people did not receive the support they needed.

We found the service had not regularly supervised and monitored staff performance to ensure that good standards of care were maintained. We found that staff had not always received the training they required to support people safely. We saw that checks were carried out to ensure staff were appropriately recruited.