Village Homecare

People's experience of using this service and what we found.

Timely calls were not always in place to provide people with the personal care they needed. Quality assurance systems were in place to measure whether people were provided with a quality service, though needed more detail to ensure all relevant care provision was checked. The registered manager followed up these issues swiftly.

Safe recruitment practices were in place to ensure only suitable staff worked at the service.

Details of how to reduce risks to people's safety were included in people's care plans. Care plans reflected people’s individual needs. Enough staff were employed to meet people's needs. People and relatives said safe care was provided, with people protected against abuse, neglect and discrimination.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives were very satisfied with the personal care that staff provided. They said they were treated with respect and dignity and staff had a caring and friendly approach to them. They said they had very good relationships with staff. Staff respected people's privacy and encouraged them to maintain their independence and do as much for themselves as they wanted to.

People and relatives were aware of how to approach the registered manager to raise concerns or complaints. The registered manager understood their responsibilities and worked in an open and transparent way.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted by evidence we received that the service had improved since the last inspection. We have found evidence that the provider has made improvements.

The overall rating for the service has improved to good based on the findings of this inspection.

Rating at last inspection

This is the 4th inspection for the service. The last inspection was in June 2019 when the service was rated requires improvement. There was a breach of Regulation 13(2) Safeguarding service users from abuse and improper treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Village Homecare is a domiciliary care agency providing personal care to older and younger adults, living with physical disability, mental health conditions, learning disabilities and autistic spectrum disorder, dementia and people who misuse drugs and alcohol. People are supported in their own houses. At the time of our inspection there were 47 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of our inspection the service was not supporting anyone with a learning disability or with autistic spectrum disorder this meant that we could not validate outcomes for people.

People’s experience of using this service and what we found

Medicines were not always given safely and in line with current best practice guidance. Medicine records lacked detail for as and when required medicines and individualised support plans for these medicines were not available. Staff were trained to recognise signs of abuse and knew how to report it. However, the registered manager had not fully understood their responsibility to notify CQC or the local authority of safeguarding concerns. Risk assessments were reviewed regularly to ensure safe care. Safe recruitment procedures meant that suitable staff were employed. Staff used Protective personal equipment (PPE) and good hygiene practices to prevent the spread of infection.

We found errors in record keeping that had not been identified through the internal auditing processes. The provider was in the process of implementing an electronic system to ensure better quality monitoring and oversight of the service. The registered manager worked in partnership with other professionals to ensure people were well supported and people received person centred care. Staff were well supported in their role and there was continuous learning and improvement.

People’s choices, lifestyle, religion and culture as well as their personal and health care needs were all included in the care planning process and the service worked in partnership with healthcare professionals. A training program meant people could be assured staff had the knowledge, skills and confidence to do their job.

Staff had a good understanding of working within the principles of the mental capacity act. However, we found records supporting people with decision making where it was felt they did not have capacity to make decisions were not in place. This meant people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the systems in the service did not support this practice.

People’s needs were met by good planning and coordination of care. Regular reviews of care meant the service could respond to changes in people’s needs promptly. People had received a service user guide and knew how to make a complaint if they needed to. The service considered people’s preferences and choices around end of life decisions and was supported by other professionals with end of life care when needed.

Staff and the management team knew people well and had developed good relationships. People were respected, received dignified care and independence was promoted and supported.

Rating at last inspection

The last rating for this service was Good (published 11 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We identified a breach of regulation in relation to the registered managers understanding of making safeguarding referrals.

Please see the action we have told the provider to take at the end of this report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service had 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.

People told us they felt safe with the staff team from Village Homecare Limited. They told us they were looked after well and their relatives agreed with what they told us. Support workers had received training on how to keep people safe and they knew what to do if they felt that someone was at risk of harm.

The management team were aware of their responsibilities for keeping people safe from abuse and avoidable harm. This included reporting any concerns to the local safeguarding authority.

Risks associated with people’s care and support had been assessed. This was so that risks could be identified and wherever possible minimised. This enabled the support workers to provide care and support in the safest possible way.

A recruitment process for recruiting new members of staff was in place. Checks had been carried out by the management team to ensure that as far as possible, only suitable people worked at the service. New support workers had been provided with an induction into the service and relevant training had been provided.

Support workers we spoke with felt supported by the registered manager and the management team. They told us there was always someone available to speak with should they need any help or advice.

Current staffing numbers were sufficient to meet the needs of people using the service.

People’s care and support needs had been assessed when they first started using the service. They had been involved in deciding what care and support they needed and in the development of their plan of care. Plans of care included people’s likes and dislikes and how they preferred their support to be delivered.

Support workers obtained people's consent before they provided their care and support. The support workers we spoke with and members of the management team understood the principles of the Mental Capacity Act 2005.

Support workers knew their responsibilities with regards to people’s medicines. Training in medicine management had been provided and this was being updated on an annual basis.

People using the service were supported with their nutritional and health needs and were supported to access health services when they needed them.

People using the service told us that the support workers who provided their care and support were caring. They told us that they were treated with respect and their dignity was maintained when personal care was provided. Relatives we spoke with agreed with what they told us.

People we spoke with told us that they had regular support workers who, on the whole, arrived on time and stayed the right amount of time. One of the nine people we spoke with had experienced a missed call. This had been looked into by the registered manager and resolved to the satisfaction of the person involved.

People using the service and their relatives knew what to do if they were unhappy with the service they received. They knew who to speak with if they had a concern and were confident that any concerns would be dealt with properly. A formal complaints process was in place, although this had not always been followed when a concern had been raised with the management team. The registered manager assured us that this process would be rigorously followed on receipt of any further concerns.

People using the service and their relatives had the opportunity to share their views on the service they received. They were asked for their opinions on a regular basis. This was through visits to people’s homes and through the use of annual surveys. The staff team also had an opportunity to share their thoughts of the service. This was through attendance at team meetings and individual meetings with a member of the management team.

The registered manager was aware of and understood their legal responsibility for notifying CQC of deaths, safeguarding incidents and injuries that occurred or affected people using the service.

The registered manager and the management team monitored the service being provided on an on-going basis. This was to make sure the care and support that people received, was the best that it could be. A business continuity plan was in place for emergencies or untoward events.