Archived: Carons Care Line

This inspection took place on the 1 September 2016 and was announced, which meant the provider knew before the inspection we would be visiting. This was because the location provides domiciliary care services. We wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

This service was managed by two registered managers who were responsible for the day to day running of the 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.

Carons Care Line is a small family run service who prides themselves on providing “unrushed care” and “finding time to talk”. People, their relatives and health and social care professionals told us they would highly recommend this service to others. Staff went above and beyond providing care and support, which were not part of people’s care packages. The service continually strived to develop further opportunities for people to go out in the community and continue enjoying activities they used to.

The registered managers spoke passionately about their service and staff. They told us they provided a service with a personal touch. They were very proud of their staff team and believed in valuing their staff as much as the people using their service. They said “We have an excellent team” and “[Staff member] love their job. They are very passionate about the job”.

People and their relatives spoke very highly of the caring approach of the service. Comments included “All the carers I have treat me as friends. I am very pleased with all of them. They cheer me up.”; “They are all wonderful. We love them all. I had a bad experience with a previous care agency, but Caron’s is brilliant” , “I am treated very kindly. The care is very good” and “They are caring, they listen to me”. A relative said “I am supported as well as my wife. They are always very positive and encourage me”.

Staff and the registered managers were very responsive to people's individual needs. Staff knew people well and what was important to them. Staff monitored people's mood and emotional well-being on a daily basis and responded accordingly. For example when a person was feeling low, staff bought the person's favourite sweets and magazines to cheer them up. Staff did this in their own time and at their own cost. Another example was when a person's watch strap broke and the person became upset. Staff left their own watch with the person while they took the person's watch to be repaired. All this was done on the staff member's day off.

Staff told us they loved working for the agency as they were allowed the time to spend with and care for people. One staff member told us they had previously worked in a Care Home, which was always rushed and did not feel they were caring for people. They said they now felt like they were making a difference. Staff told us they provided care with a personal touch and people and relatives we spoke with confirmed this. One staff member said “It is the norm. I treat people the way I would like to be treated.”

People using the service and their relatives said they valued the relationships they had with staff and were satisfied with the care they or their family member received. People were supported to have a say in how their care was delivered.

One of the registered managers specialised in palliative care and had a small dedicated team providing end of life care for people. One relative said “They cared for my mother during her last few months. The carers were compassionate and professional and enabled my mother to die at home as she wished. The team of carers all went the extra mile, which involved [the manager] having to step in personally when one of the team was unwell.

Staff were aware of the types of abuse people may be at risk of and the actions to take if they suspected someone was at risk of harm. Staff were aware of their responsibility to report any concerns they had about people’s safety and welfare.

People received their care at the correct time and had support given by the same members of staff to ensure consistency of care. Staff would support people on end of life care beyond their allocated care time.

There were enough staff deployed to fully meet people’s health and social care needs. Appropriate recruitment processes were in place to reduce the risk of unsuitable staff being employed by the service. Staff received training and support from management to ensure they had the right knowledge and skills to meet people’s needs.

Systems were in place to ensure people were given their medicines in a safe way.

People told us staff sought their consent before providing any care or support. Staff had an awareness of the Mental Capacity Act (2005) and knew how to support people to make their own decisions.

There was effective communication systems in place to ensure any changes or updates about people were communicated to staff immediately. Any changes in people’s health or emotional well-being were responded to straight away.

People’s needs were assessed and care plans developed to identify the care and support people required. People and their relatives told us they were involved in the planning and reviewing of their care and support and that when they required changes to be made, this was actioned by staff or the registered manager.

People and their relatives told us they knew how to raise any concerns or make complaints should the need arise. The registered manager sought feedback from people to ensure that the quality of care was maintained.

People, relatives and staff all spoke positively about the management of the service. Staff felt supported and confident in raising concerns and felt the registered managers would act on these.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found '

Is the service safe?

People told us that they felt safe when staff supported them in their home. They told us that staff treated them with dignity and respect. During the day we spoke two people who used the service and two relatives. One person told us "they are very good, good as gold'. Another person told us 'they go out of their way to ensure my wishes are dealt with' and 'they do things the way I want'. All of the comments made were of a positive nature and confirmed that the person and their relatives were happy with the support received

People's safety was promoted because the service obtained advice and support from other health and social care services that people required in order to meet their needs effectively.

Staff had attended safeguarding training and knew how to recognise and report abuse. They demonstrated good awareness of safeguarding issues and their responsibilities in reporting concerns. They confirmed that they would feel comfortable raising and reporting any concerns with the manager.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications have been submitted, appropriate policies and procedures were in place. Relevant staff had received training in the Mental Capacity Act and the application of DoLS.

Is the service effective?

People's needs were assessed and they told us that they were involved in planning their care. People we spoke with told us 'they do things the way I want' and 'everything is done very well, brilliant'. We saw from the care records kept in their home that they were involved in making decisions about their care and that these were respected by staff.

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. This ensured their needs were clearly identified and the support they received was meaningful and person centred.

Is the service caring?

The people and relatives we spoke with confirmed staff treated them in a respectful manner. They confirmed they had not had any missed calls and that support workers arrived on time. All the comments we received were of a positive nature and confirmed that the person and their relatives were happy with the support received.

Support workers had sufficient information about people's needs and how they should be cared for. This included their preferences and the things that were important to them. The care records we looked at when we were at the agency office, demonstrated that people were consulted about their care needs and that the service offered had been tailored to the individual.

Is the service responsive?

People's care had been reviewed regularly. Other agencies were consulted when there were changes to people's care. All those involved in the person's care were aware of changes so they could respond appropriately and consistently. Positive comments were received from a healthcare professional about the way the agency responded to people's changing needs.

Staff confirmed they reported any concerns to the manager on the same day and that appropriate action was taken to ensure people's care and welfare needs were met.

Is the service well-led?

People were asked for their views about the service to help ensure their views contributed towards improvements and further development of the service.

The service had quality assurance systems in place so that shortfalls could be identified.

Although the agency was small there was a clear staffing structure in place. Staff we spoke with were clear on their roles and responsibilities and there were defined reporting lines so all staff knew who to report to.