We carried out a review of the data available to us about Quality Care Devon 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 Quality Care Devon, you can give feedback on this service.
Not everyone using Quality Care Devon received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 114 people receiving personal care.
The service had 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.
At the last inspection in August 2016 the service was rated Good overall. At this inspection we found the evidence continued to support the rating of Good 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.
Why the service remained rated Good.
People commented; “We are very well looked after and cared for” and “The best I’ve had, couldn’t have better”. A relative said; “I need to know my loved one is treated with respect, and they are.”
People continued to be safe using the service. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People had their needs met by suitable numbers of staff, with extra staff support provided when required.
Peoples’ medicines were managed safely. Staff completed medicines training and knew and understood the importance of safe administration and management of medicines.
People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected. Staff completed safeguarding training.
Peoples’ risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to help support and enable people to retain as much independence as possible and help reduce risks from occurring. Risks associated with people's care and living environment were effectively managed to ensure their freedom was promoted.
People received effective care from staff who had the skills and knowledge to meet their needs. Staff confirmed they attended team meetings, received one to one supervision and appraisals to monitor their practice. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity policy of the company.
People were enabled and supported to lead fulfilling, independent and active lives. 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.
People's human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA).
People who required assistance with their food, made a choice of meals, snacks and drinks they enjoyed. Staff monitored people's health and well-being and made sure they had access to other healthcare professionals according to their individual needs.
People continued to receive a service that was caring. Staff demonstrated kindness and compassion for people through their conversations and interactions. If people found it difficult to communicate or express themselves, staff offered additional support and showed patience and understanding.
People could make a complaint and were confident action would be taken to address their concerns. The registered manager treated complaints as an opportunity to learn and improve. The complaints procedure was available in an easy read version to assist people.
People’s communication needs were known by staff. The service remained responsive to people's individual needs and provided personalised care and support. People received information in a format suitable for their individual needs. Throughout the inspection we saw evidence of how the registered manager and staff understood and promoted people's rights as equals regardless of their disabilities, backgrounds or beliefs. People’s equality and diversity was respected and people were supported in the way they wanted to be.
The service was well led. The provider had systems in place to monitor, assess and improve the service. There was an open culture, and people and staff said they found access to the office and registered manager welcoming and easy. Staff were positive and happy in their jobs. There was a clear organisational structure in place.
The provider worked hard to learn from mistakes and ensure people were safe. The registered manager and provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.
The service has a registered manager, although they were not available at the time of the inspection. 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 inspection was undertaken over a three day period, 10, 15 and 17 August 2016 and included visits to the office, staff interviews and visits and telephone calls to people in their own home. At the time of this inspection 128 people were using the service.
This was the first inspection of this service since it registered with the Care Quality Commission, (CQC).
The majority of people we spoke with said the service was well managed. One person said, “They deal with everything I ask them to” and another said, “I can’t find fault at all.” Any reservations people had related to the changes made to the care staff rotas, although two people said they had a delay in obtaining a response from the office staff, and didn’t always feel listened to. The registered provider was aware of these issues and was taking practical steps to resolve these and improve the service. They had invested in a new electronic monitoring system; provided staff with smart phones to enable them to access their rotas electronically; provided satellite navigations systems for staff; purchased pool cars for those staff who did not have their own car; paid for staff to take their driving test and provided a fuel card so staff did not have to purchase fuel themselves. The registered provider was confident these changes, along with creating geographical staff teams and strengthening the management structure, would ensure people received a more consistent service.
All of the 16 people and five relatives we spoke with told us the staff provided safe care and support. One person said, “I don’t have any qualms about that. I always feel safe.” Five people told us that sometimes their carers arrived late and two people told us they had occasionally had a missed visit. All said they were usually informed by telephone if the carer was running late. However, one person and one relative said staff had been very late and they had not been notified. One said the staff had been so late they had put themselves to bed, which was a risk to them, and the relative said their relation had become very distressed.
Some people told us they felt there were not enough staff to meet the service’s obligations to people, as they had experienced late visits or had their staff changed at short notice. Eight people were concerned about the number of changes made to their planned staff rota. One person said, “We very rarely have the same staff” and another said they were not sure who was coming to them until they arrived. We discussed this with the registered provider. They said there had been a period when the service needed to recruit more staff and this, along with the changes made to the staff teams, had resulted in periods of change for people. They were confident this would all now be resolved.
Staff recruitment practices were safe and relevant checks had been completed. All four files we saw included the necessary pre-employment checks, including proof of identify, previous employment references and a disclosure and barring service (police) check. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy. One member of staff said the service was very good at looking after people’s welfare: they said, “We keep an eye on people, make sure they are safe.”
Risks to people’s health and safety had been assessed and regularly reviewed. These assessments included information and guidance from health care specialists about how to minimise the chance of harm occurring to people and staff. The service supported some people to take their medicines. The care plans provided information about each person’s medicines and why they were prescribed. People told us the staff supported them safely and they received their medicines as prescribed.
People spoke positively about the care staff, describing them as “good” or “very good”. Each person we spoke with told us the staff were respectful, kind and caring. One couple told us, “We are so happy with the people who are looking after us. They show us every care and enormous respect for us and our home.” People told us staff did ‘little extras’ for them, such as hanging out washing and bringing milk and newspapers. One person said, “They always bring me the paper at the weekends so I can follow the football.” The service had received 23 compliments since January this year from people and their relatives. These thanked the staff for their care and kindness.
Staff told us they enjoyed their work and received a great deal of personal satisfaction from caring for people. One staff member said, “I thoroughly enjoy it. It’s so rewarding making a difference to people’s lives, many of whom only see their carers.”
Care plans were developed with each person and people told us they had received a copy. These plans described the support the person needed to manage their day to day needs. Staff knew people well, and were able to tell us how they supported them. Staff recorded the care they provided at each visit and we saw these records were detailed and clearly written. The service was flexible and responsive to changes in people’s needs. One person told us, “This company are the best we have ever had. They will accommodate changes we request in relation to the times of visits, especially at the weekends.”
All but one of the people and relatives we spoke with said they felt able to raise a complaint with the service: some told us they had done so this year. They said they had been listened to and appropriate action had been taken to deal with the issue. The service had received six complaints since January 2016 and records of the action taken to investigate each complaint and how the matter had been resolved were maintained.
The service periodically reviewed the quality of the service people were receiving. People told us they had received questionnaires and telephone calls from the office staff asking them if they were happy with the care and support they received. The results of the most recently sent questionnaires in February 2016 showed a high level of satisfaction with the service. Monthly audits and unannounced checks on staff performance were also carried out to monitor the quality of the service.