Crescent Homecare Limited

Updated 5 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection site visit activity took place on 31 July 2018. It included a visit to the location to speak with the registered manager and to review care records, policies and procedures and carried out face to face interviews with staff. We also spoke with people and their family members during telephone conversations. The inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed all the information we held about the service, including previous inspection reports. We also examined notifications received by the Care Quality Commission. We contacted the local authority safeguarding and commissioning teams and Healthwatch. Healthwatch are a consumer group who champion the rights of people using healthcare services.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the registered manager, the operations manager, a supervisor, and five care staff. We spoke with nine people who used the service and seven relatives over the telephone.

We looked at six people’s care plans, risk assessments, three staff files, policies and procedures, surveys, meeting minutes, six people’s medicines records, audits, scheduling system and associated processes.

Updated 5 September 2018

This inspection site visit took place on 31 July 2018 and was unannounced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses. It provides a service to older adults. On the day of our inspection there were 165 people receiving the regulated activity of personal care.

Not everyone using the service receives regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were consistently supported to have choice and control over their own lives from being supported by sustained person-centred care. Person centred care is when the person is central to their support and their preferences are respected.

We found the culture of the service was extremely positive, person centred, inclusive and forward thinking. We spoke with a range of professionals, families and staff who were confident that crescent always went above and beyond their remit to enable and support people. Staff had excellent knowledge of people’s likes, dislikes, preferences, mobility and communicative needs.

The service was extremely well led, leadership, management and governance of the service assured the continual delivery of high-quality, person centred care by staff who worked within an open and fair culture.

The management was very passionate about ensuring staff were always valued highly, supported, equipped with information and empowered to be confident, attentive, caring and knowledgeable.

The service was committed to valuing community engagement and developed positive partnership working. By establishing working relationships with community groups and organisations in the local area.

The service showed continual commitment and dedication and went over and above their remit in ensuring clients received their care in adverse weather conditions.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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 had extensive experience of working in the social care sector and a passion for valuing people and staff.

Staff, people who used the service, relatives and other professionals agreed that the registered manager led the service very well and was always approachable and accountable. We found they had excellent knowledge of the needs of people who used the service and clear expectations of staff. They had plans in place to make further improvements to service.

People were actively supported to maintain their independence by staff that were patient, equipped with information and knowledge and valued the importance of this.

People who used the service and their representatives were regularly asked for their views about the support through questionnaires and feedback forms and visits that were responsive and proactive.

Care plans were person-centred and covered giving members of staff and external professionals relevant information when providing care to people who used the service. Care plans were reviewed regularly with the involvement of people who used the service and their relatives.

Notifications of significant events were submitted to us in a timely manner by the registered manager.

Medicines administration was safe. This was regularly audited and staff competencies monitored by senior staff.

People were supported to take risks safely and personalised risk assessments were in place to ensure people were protected against a range of risks.

Staff had received safeguarding training and were able to describe types of abuse and what they would do to report concerns and protect people.

New staff received induction training and were accompanied and supported by dedicated mentors called ‘care coaches’ to enhance their induction and extend it if necessary.

There were sufficient staff to meet people’s needs safely, with travel time included and supervision checks undertaken to ensure staff completed care visits as agreed.

Staff were trained in safeguarding, first aid, moving and handling, the Mental Capacity Act, infection control and food hygiene. Additional training was in place or planned in areas specific to people’s individual needs.

The registered manager displayed a sound understanding of capacity and the need for consent on a decision-specific basis. Consent was documented in people’s care files and people we spoke with confirmed staff asked for their consent on a day to day basis.

A programme of audits was carried out by the registered manager and these were effective at improving the service.

People and their relatives were able to complain if they wished and were knowledgeable of how to complain or raise minor concerns.