Archived: Second 2 None Healthcare Ltd

Below is a summary of what we found. The summary describes what people using the service told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report. This is a summary of what we found:

Is the service safe?

People were satisfied with the care and support they received. People told us that the staff were professional and kind. People we spoke with told us they felt staff listened to them and acted on what they said. The provider worked closely with the local authority and we spoke with two care managers who were positive about the service that the agency supplied to people. We saw that safeguarding issues had been reported to the local authority so issues could be considered under their safeguarding of adults procedures. Staff had received training about safeguarding people from abuse at their induction and this training was about to be delivered to all staff again to help to protect people.

The provider had systems in place to monitor the quality of service provided to people to ensure people remained satisfied with the service they received. However we did find that there were some shortfalls in the recruitment process which could have placed some people at risk of harm. We have asked the provider to address the issues found.

Is the service effective?

People's health and care needs were assessed. Where possible people signed their care plans and were involved in stating what care and support they wished to receive. Risk assessments were in place to inform staff of any issues within people's home environment or advise staff about risks to people's wellbeing. Staff we spoke with told us that they recorded all the care and support they gave to people before they left a person's home. This helped to inform all parties. A person we spoke with said "I am pleased with the service. The girls are always here on time, they look after me well. They are lovely polite, kind and caring. I read my care notes last week. They reflected the care I needed. They (the staff) know what they are doing. I have no issues.' A relative we spoke with said 'I am happy with the care X receives. They are doing a sterling job. They (the staff) always listen to me and discuss the care needs with me, where necessary.'

Is the service caring?

We spoke with people using the service and with some relatives. We received the following comments: "Staff treat X with respect and they give X time if he does not want to cooperate on a morning. They leave X for ten minutes and then go back and try again: they never give up and don't rush him. The staff are always patient with him." and "They (the staff) treat dad with respect at all times, they don't rush him and at this time we are happy with the service provided." Staff we spoke with told us that they loved their work and enjoyed caring for people. The manager was seen to try her best to provide people with the help and support they needed to receive even if this was challenging at times. A relative we spoke with told us that the agency was well named because the service that was provided for their loved one was 'second to none'.

We were told by the manager that they always informed the care managers if people's needs changed and more help and support was required. We saw from the care records we looked at that the care staff recorded in detail all the care they provided to people. People we spoke confirmed that the care staff were patient, professional and kind.

Is the service responsive?

There was a complaints policy in place which people were made aware of. People we spoke with said they would raise issues with the manager or staff. A phone number was provided so that people receiving a service or staff could gain help and advice at any time from the manager or deputy manager. This helped all parties to feel supported and ensured that any issues could be acted upon in a timely way.

The manager told us how people were treated as individuals by the staff. We saw whilst we were visiting the agency that people who required another care call were accommodated to ensure people received the care they required. People we spoke with including care managers valued the flexibility and attention to detail provided to people.

Is the service well-led?

The manager had put systems in place to monitor the quality of the service. These systems were being reviewed and developed. People were regularly asked for their views about the service they received by phone or through questionnaires.

The service worked well with the local authority to ensure people received the care and support they required.

Staff told us there were clear roles and responsibilities in place. Staff told us that they valued working for this provider and said they felt well supported at all times by the management team. However we did identify some occasions when the service did not adhere to its own policies and procedures for recruiting staff which compromised people's safety.

Staff who spoke with us said that they always tried to ensure they treated people who used the service with dignity and respect. They told us there was travelling time allowed in their rota. This meant they were able to give extra time to people on occasion.

We saw several care plans and these identified the level of support each person needed. They also contained risk assessments. The documents had been signed by the person they were about.

People told us that they felt safe when receiving care and if they had any concerns they would report them to the manager. Staff told us that if they had any concerns about the people they were supporting then would tell the manager. People who used the service and their relatives told us 'If I had to complain I am confident they would listen to my concerns and act on them'.

We saw staff records and these indicated that people had been thoroughly checked prior to their recruitment. This ensured they were suitable to work with people who may be vulnerable.

We saw evidence that staff had received training in the safe handling of medication. They had clear instructions as to how they must handle medicines in people's homes. Staff explained the processes they used when administering medications and confirmed they signed the medication administration records each time they administered medication.

They told us that the care packages provided were reliable and the carers followed the care plan. One stakeholder told us "The communication is very good with the agency and if there are any problems or changes to the service they contact us immediately". Another stakeholder told us "The service provided is generally very good and we don't have any problems with it". The stakeholders also spoke to people using the service and they confirmed that they were pleased with the service and staff always turned up when they were expected.

We spoke to two stakeholders and they told us that the people receiving the service had told them they thought the staff were kind, well trained and always stayed for the length of the contracted visit. They felt safe and well supported by the service provided. We spoke to three staff and they told us that they had regular training sessions. Each person had completed medication administration and moving and handling training. Training was provided through shadowing experienced staff, direct training provided by the management, DVD's and distance learning courses.

We spoke to three members of staff. They were staff who assisted people as a second carer, they confirmed that they followed the care plan and there was always two carers used when assisting someone in a hoist.