Cygnet Care (Devon) Limited

Updated 3 January 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 checked 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.

This inspection site visit took place on 4 December 2017 and was announced. We gave the agency 48 hours’ notice of the inspection visit because the manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. We visited the office to see the manager and office staff; and to review care records and policies and procedures. Inspection site visit activity started on 27 November 2017 and ended on 7 December 2017.

This was a routine comprehensive inspection carried out by one adult social care inspector.

The inspection was informed by feedback from questionnaires completed by a number of people using the service. The Care Quality Commission sent surveys to 21 people and their relatives (we received seven responses) and nine to community professionals (we received three responses). We visited two people in their own homes and spoke with them and one relative. We met and spoke with the registered manager and two office staff. Following the inspection, we spoke with five people, three relatives and five members of staff. We also contacted five health and social care professionals and received a response from three of them.

We used information the provider sent us in the Provider Information Return (PIR). 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. We also reviewed other information we held about the service. This included previous inspection reports, safeguarding alerts and statutory notifications. A notification is information about important events which the service is required to send us by law.

We reviewed information about people’s care and how the service was managed. These included: two people's care files and medicine records; two staff files which included recruitment records of the last two staff to be appointed; staff rotas; staff induction, training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incident and accident reporting; minutes of meetings and the most recent quality questionnaire returned.

Updated 3 January 2018

Cygnet Care is registered with the Care Quality Commission (CQC) as a domiciliary care agency. It provides personal care to a range of older adults and younger adults living in their own houses and flats in the community. This included people living with dementia, a mental health illness, a physical disability, a learning disability or sensory impairment.

At the time of inspection, there were 37 people receiving a service from the agency. Although the majority of people using the agency received a regulated activity, six received support visits only. 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 take into account any wider social care provided. The time of visits ranged from 15 minutes to two hours and 15 minutes, with the frequency of visits from once a week to six times a day. There was one person who required two care workers at each visit to support them. There were 14 full and part-time staff employed.

There was registered manager in post. 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.

At the last inspection, the service was rated as good in five areas, with an overall rating of good.

At this inspection, we found the service remained good in four areas and outstanding in one area. The overall rating remained good.

The registered manager and care workers provided people with a bespoke service and delivered care and support which took into account people’s individual choices and preferences. People were very happy with the service they received. Care workers treated people with respect, dignity and compassion at all times. Meaningful relationships had been developed with the care workers who supported them. Families, friends and pets were involved in their care, support and wellbeing. A relative said, “My (family member) is very happy to see her ‘friends’ (care workers) and appears to be more relaxed after their visits” and a friend said “(Friend) feels very comfortable with your carers and looks forward to (care worker’s) visits very much.” People were encouraged to be as independent as possible by care workers they trusted and felt safe with.

Care workers supported people to lead an enhanced quality of life. People commented, “During the time carers came to help (family members), the care and time given has been wonderful. They both enjoyed their carer’s visits and were always happy with the care given … more like friends”; “All the carers are really good”, and “They will do anything.” People said care workers went ‘the extra mile’ and the agency put people at the heart of their service. The agency went above and beyond what was expected of them and due to the small size of the agency, delivered a personal service where the registered manager knew each person extremely well and visited them regularly. Caring for people’s wellbeing was an important part of the agencies philosophy. Care workers regularly carried out duties over and above what was expected from them.

Meaningful relationships had developed between staff, people and their relatives. Friends and family were involved in people’s care and spoke highly of the agency. People had a regular team of care workers and felt they had become part of the extended family.

People were kept safe and cared for by care workers who were aware of their safeguarding responsibilities. Care workers were safely recruited, trained and supervised in their work. They enjoyed their jobs, felt included and listened to in the running of the agency.

People had confidence in the management of the service and the registered manager acted as a role model for the staff team. People were confident any issues would be dealt with appropriately. One person commented, “(Registered manager) is a lovely kind person … we were recommended for this service.” A health care professional said, “They provide excellent care to our clients in a very professional manner.”

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. Care workers had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support.

Each person had risk assessments and a care plan in place. People and their families were involved in the planning of their care and these were regularly reviewed. When changes in care support were required, these were carried out in a timely way. A relative commented, “I would like to say a big ‘thank you’ for everything you did to accommodate the ever changing needs of my parents … it was so reassuring for me to be able to talk to you knowing that you would do all that you could to help.”

Care workers had been trained to give people their medicines safely and ensured medication administration records were kept up to date. Care workers supported people to eat a nutritious diet with food and drinks of their choice. In between care visits, care workers always made sure people had snacks and drinks available.