Archived: Aylsham Homecare

Aylsham Homecare provides a domiciliary care service to a total of fifteen older people, some of whom may be living with dementia. The service delivers care and support to people in their own homes in Aylsham and the surrounding area.

There was 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. The registered manager was also the registered provider of the service.

People and their relatives told us that they would recommend the service. They spoke of a caring service that they could rely upon. People told us that the staff were capable in their roles and went beyond people’s expectations to deliver a service; that they went ‘the extra mile’. People spoke highly of the management team and described them as professional, meticulous and efficient.

Checks were completed on potential employees to ensure they were suitable to work in health and social care and that they had the skills and knowledge to deliver the service. There were enough staff to meet people’s individual needs in a person-centred manner and at a time of their choosing.

People benefited from receiving care and support from staff that had been effectively trained and introduced to the role. Staff received a flexible induction and this was carried out by the management team to ensure competency in the role. Staff told us that they felt supported, received regular supervisions and had their competency for the role regularly assessed.

Staff had built trusting relationships with each other, the management team and the people who used the service. They worked well as a team and their flexible approach ensured the service was reliable. Staff understood the positive impact achieved by maintaining a person’s dignity and independence. People told us they felt respected, listened to and treated as an equal.

Processes were in place to help protect people from the risk of abuse. Staff had received training in this and demonstrated that they understood how to protect, prevent, identify and report potential abuse. They were aware of the different types of abuse and the associated symptoms that may indicate a person was being abused. The registered manager had reported concerns in the past as required.

The individual risks associated with the people who used the service, and the staff, had been identified, assessed and appropriately managed. These had been regularly reviewed. Accidents and incidents had been recorded and the management team had taken the appropriate action.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service adhered to the five principles of the MCA and the management team had a good understanding of this. Staff had received training in MCA but their knowledge was variable.

A person-centred service was being delivered and people spoke of a service that met their needs, was flexible and delivered a high quality, personal service. Care and support plans had been developed with the person and the management team had spent time building relationships in order to further enhance the service being delivered. People’s care and support plans gave staff enough information to perform their role. The staff and management team knew the people who used the service well.

Staff assisted people to maintain relationships, hobbies and interests where required. The service was flexible which allowed people to follow their interests and access the community. Where needed, staff assisted people on activities outside of their home. If people required assistance to prepare meals or meet their nutritional needs, this was received.

People benefited from receiving care and support from staff who knew them and their health needs well. Staff had the knowledge to prevent and identify health deterioration. Where and when needed, staff assisted people to access healthcare services and made appointments for them as required. People and their relatives spoke of a proactive service that was attentive to people’s needs.

The staff and management team were enthusiastic about the service they delivered and demonstrated that they strove to improve. Feedback from people was encouraged and via a route that was preferable to each individual. The management team had a good overview of the service being delivered and regularly visited the people who used the service to gain their feedback and make themselves available. Staff meetings were held regularly.

At the June 2014 inspection we identified from records held by the service that staff recruitment processes were not robust enough to minimise the risks of unsuitable staff being employed by the service. We also found that people's care records were not retained in the office and there were no records to support staff supervisions. These concerns meant that the service was not operating safely because of the risks presented by these issues.

During this inspection we spoke with the provider. We reviewed care records in relation to eight people, recruitment information in respect of two staff members and other records relating to the management of the service.

Is the service safe?

This inspection established that improvements had been made. The records we viewed showed that the recruitment processes in place minimised the risks of unsuitable staff being employed to look after vulnerable adults. People's care plans were now kept in the service's office as well as at people's home. We were also satisfied that records demonstrated that staff were being appropriately supervised.

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

Is the service safe?

People we spoke with told us they felt safe with the service's staff. One person told us that staff were 'meticulous with my safety during showers so I don't slip.' Another person had been informed about pendant alarms by the service which they now used.

We found that staff recruitment procedures needed improvement to ensure that all necessary steps were taken so that staff recruited were fully vetted. Some aspects of the service's records arrangements also required improvement.

This inspection established that there were no concerns that people using the service were being deprived of their liberty or lacked the mental capacity to make their own decisions. The provider was aware of their responsibilities in these areas should such concerns arise.

Is the service effective?

People told us that staff were never late for support visits. One relative we spoke with told us, 'They have never let us down. They are absolutely marvellous and very professional.' Another person we spoke with told us that the care and support their family member received was 'consistently good.'

Staff received appropriate training and an annual appraisal system was in place. The formal staff supervision process had not yet been implemented.

Is the service caring?

People told us that staff looked after them well and treated them respectfully and kindly. Some people mentioned how well they got on with the staff and that they considered them as friends as well as carers.

We were told of examples where people felt the service went above and beyond what was required of them. One relative told us how if staff had finished their agreed tasks early they were pro-active in doing other odd jobs around the house with their family member's permission.

Is the service responsive?

The service was flexible in providing additional support to people at short notice. One relative visited their family member each evening so no evening support visit was required. However, sometimes the relative worked away from home. The service was able to step in and carry out evening support visits as necessary during these periods.

People knew how to make a complaint if they had any concerns about the support they received. 'I can't imagine that would happen, but I'm sure if it did, my complaint would be properly dealt with' one person told us. The service had an appropriate complaints procedure in place.

Is the service well-led?

The provider had implemented an effective survey to obtain people's views. They kept in frequent contact with people using the service to ensure that their needs were being met and they were satisfied with the service they received.