We carried out a review of the data available to us about Holywell Domiciliary Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Holywell Domiciliary Care Services, you can give feedback on this service.
Holywell Domiciliary Care Services is a Domiciliary Care service. At the time of the inspection 80 people were in receipt of care in their own homes.
People’s experience of using this service and what we found
The registered manager confirmed they would ensure records relating to staff performance and disciplinaries were completed in full, we made a recommendation about this. People told us they felt safe. Systems were in place to record and act on any concerns. Visits were allocated on a computerised system. People told us sometimes their visit times were changed, but said they were informed of this. Staff were recruited safely. Medicines were managed well.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff had undertaken a range of training, which supported them to deliver effective care to people. All people we spoke with told us they were happy with the skills of the staff team. Staff always asked for permission before undertaking any care or activity with them. People told us they were supported with their food and fluids.
All people and relatives we spoke with told us people who used the service received good care from the staff. People were treated with respect, their privacy and dignity was maintained.
Care files contained information about how to support people’s individual needs. People we spoke with confirmed they had been involved in their development. Peoples individual communication needs were generally considered.
Systems to deal with complaints were in place. Positive feedback was seen. The service asked for people’s views. We received positive feedback about the registered manager. The registered manager understood the operation and management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was rated good at the last inspection (Published on 3 December 2016).
Why we inspected
This was a scheduled inspection based on the previous ratings.
Follow up
The service will be re-inspected as per our inspection programme. We will continue to monitor any information we receive about the service. The inspection may be brought forward if any risks are identified.
Holywell Domiciliary Care Services provides care and support to people in their own homes. The domiciliary care service provides assistance with practical and personal support. The agency works with people who have a range of mental health, learning and physical disabilities. Holywell, which forms part of a company that has two other services, has its office based in Preston.
The agency has a registered manager in post. 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 who used the agency told us this was a reliable and well-run agency. They told us they knew how to raise concerns and complaints but all those we spoke with said they had not needed to complain formally. They told us they felt confident talking to the registered manager about anything that bothered them. They had been asked for their opinions and views and if they were happy with the services they received. Relatives we spoke with were aware of how to raise concerns or complaints.
People we spoke with who used the agency told us that they felt the staff had a good understanding of their needs and preferences. They told us they felt safe whilst receiving support from staff at the service.
Staff we spoke with had a good understanding of possible indicators of abuse and told us what action would be taken should they become aware of any concerns. We saw that the provider had taken action to act on any concerns and minimise individual risks to people.
The agency followed the requirements of the Mental Capacity Act 2005 Code of practice and staff had training on this and a range of training relevant to their roles. We saw that people were supported to maintain their independence and control over their way of life as much as possible. Risk assessments were in place to allow people to keep their independence in their homes in ways that mattered to them. We have made a recommendation that the registered manager considered ways to make the information on Powers of Attorney clearer for staff.
People told us that staff were caring and friendly. People had been involved in planning their care and people were able to tell staff on a daily basis how they wanted their care delivered. People told us that their care needs and preferences had been reviewed with them but we saw that care plans were not always updated following a review to reflect the person’s current needs.
Agency staff who administered medicines had received training in safe medicine administration. We have made a recommendation that the registered manager found out about the current guidance on care planning for people who were taking controlled drugs.
Staff told us they felt well supported in their role and were able to seek advice at any time of the day. There were systems in place for staff to feedback any concerns or changes in care needs to the registered manager.
The staff we spoke to knew about the people they were supporting and the choices they had made about their care and daily lives and respected their wishes. People using the agency felt the staff had a good understanding of their needs and preferences.
There was a recruitment system in place that helped the employer make safe and appropriate recruitment decisions when taking on new staff. We have made a recommendation about the need for the registered manager to reinstate a system to formally record checks on driving documentation so this can be monitored.
We saw new staff had received a structured induction and essential training at the beginning of their employment
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
Is the service safe?
People told us they felt safe when receiving care from Holywell. People told us that they felt their care and support was of a high standard. The people we spoke with stated they consistently found staff to be respectful and supportive towards them. One person told us, "I feel very happy and safe in their care. They know what they're doing".
People told us they felt safe when being cared for by staff who had been appropriately recruited. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected. We found that safeguarding procedures were robust and staff understood how to safeguard people they supported.
Holywell had an effective system in place to ensure managers and staff learnt from untoward incidents. This included accidents, incidents, complaints, concerns, whistleblowing and investigations. This meant the provider reduced the risks to people and helped the service to continually improve.
Is the service effective?
People's social, health and support needs were assessed with them, and they were involved in care reviews. Support plans were individualised, signed, dated and reviewed jointly by the person concerned and their carer. One relative told us, 'The staff are very engaging and empathetic'.
We observed that Holywell worked effectively in ensuring people had consented to their care. The service had good recording mechanisms and confirmed people consented prior to support being provided.
Is the service caring?
We spoke with people and their relatives to gain an understanding of their experiences of receiving support from Holywell. Their response was very positive. A relative said, 'I cannot fault my husband's care. They're amazing and go that extra mile'.
Staff explained that they worked in a caring and friendly manner. They described being respectful to and working with people to understand their needs.
Is the service responsive?
People's needs were assessed before they accessed the service. This meant Holywell was able to confirm that they could meet the individual's support needs. Care was reviewed regularly with the individual concerned to meet changing needs. One relative told us, 'They sat down and discussed my husband's care with me. They check regularly if his needs have changed'.
People also confirmed that carers did not just complete allocated tasks. Several people spoke about staff having a caring and friendly manner. People felt carers often relieved their boredom and provided activities to occupy their minds.
Is the service well-led?
Holywell had a range of quality audits in place. Other regular processes underpinned this, such as satisfaction surveys, staff supervision and team meetings. We observed that the service was continuously seeking ways to improve its quality of service.
Staff told us they were clear about their roles and responsibilities. One person told us, 'You couldn't get a better boss than the managers we have. They're firm, but supportive'.