Care Response provides personal care to older adults, some of whom have dementia throughout Ascot, Bracknell, Old Windsor and surrounding areas. The office is located in the main street of Sunninghill just outside of Ascot, Berkshire. Staff provide care to people within an approximate 10 mile radius of the office. The service promotes the independence of people by supporting them at home. Care calls range from 15 minute ‘pop in’ visits to one hour and above. People structure these calls to suit their needs. Services provided range from assistance in the morning (including helping people get out of bed, wash, get dressed and have breakfast) shopping, preparation of food, medication prompting and assistance with evening care routines. At the time of the inspection, there was a registered manager. 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 most recent inspection was a desk-based review in September 2014, following outstanding non-compliance from a prior inspection on 5 February 2014. A desk-based review meant the inspector had assessed it was not necessary to perform a site visit, and instead reviewed documentation and other evidence sent by the provider. The desk-based review checked whether the service had improved in assessing and monitoring the quality of the service and supporting staff. These outcomes were found compliant at the time. A full history of the service’s inspections and reports is available on our website. This is the first inspection and rating of the location under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Care Act 2014.
At the time of the inspection, 54 people used the service and there were 20 staff. People received care visits in the morning, at lunch time, at supper and in the evening. The service operated from 7am to 10pm each day and people, relatives, staff and healthcare professionals could telephone the office anytime to receive support. After hours, calls were diverted to the on-call manager’s mobile telephone.
People were protected against abuse or neglect. Staff we spoke with were professional and caring and enjoyed working with people who used the service. People’s opinions of the care provided were consistently positive. There were sufficient staff to meet people’s needs at all times, and the service appropriately determined correct staff deployment. People’s medicines were administered, stored and documented appropriately.
The service was not consistently effective. Staff received induction, training, supervision and performance appraisal for their roles. The service utilised Skills for Care’s ‘Care Certificate’ for new care workers and there was evidence they had successfully completed the many components. However, we found that progress through the ‘Care Certificate’ was too rapid for new staff and there were gaps in ongoing staff supervision dates. Recruitment and selection of new staff members was robust and ensured safety for people who used the service. Consent was gained before care was commenced and people’s right to refuse care was respected by care workers. However consent was not always gained lawfully by the service from the relevant person. We made a recommendation in the report regarding gaining lawful consent.
We found staff were kind and generous. People’s comments mirrored our findings from the inspection. Staff told us they respected people’s privacy and dignity, and ensured people remained as independent as possible. People had regular opportunities to provide feedback to the service and also have their say in how things operated.
The service was responsive to people’s needs. People had the ability to share their compliments, concerns and complaints in an open and transparent manner. Where feedback was provided by people or relatives, management would undertake necessary investigations, make changes to their care package and report back to the person who complained. People’s care plans were person-centred and changed as necessary. We found evidence that the care documentation was a good reflection of the person who was cared for.
All of the people and staff we spoke with as part of the inspection commented that the service was well-led. They felt that the managers took time to listen and would take action to make improvements when needed. People felt that management were approachable and had a visible presence in the operation of the service. We found that the management conducted checks to assess the standard of care. This included satisfaction surveys where people consistently rated the service very good. However we identified areas for improvement and the management took immediate action.