Family Care Solutions

Updated 12 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.

Inspection site visit activity started on 9 July and ended on 16 July. This included a visit to the office, home visits to people using the service, and telephone interviews with people using the service, relatives and staff. The service was given 48 hours’ notice of the inspection. This was to ensure that somebody would be available in the office to answer any questions during the inspection. The inspection team included two adult social care inspectors 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 service. The expert-by-experience had personal experience of caring for older adults and adults with learning disabilities.

We visited the office location on to see the manager and office staff; and to review care records and policies and procedures. The expert-by-experience undertook telephone calls to people using the service and their families and an adult social care inspector completed telephone interview with staff.

Before the inspection we reviewed the information that we held about the service and registered individual. This included any notifications and safeguarding information that the registered individual had told us about. Statutory notifications are information that the registered individual is legally required to tell us about and included significant events such as accidents, injuries and safeguarding notifications. We also looked at information provided through the ‘share your experience’ portal available on the Care Quality Commission (CQC) website.

We liaised with the local authorities, other local commissioners of service, other agencies that the service had informed us they worked with and Healthwatch. Healthwatch is an independent organisation which collects people’s views about health and social care services. None of the services we contacted shared any concerns about Family care solutions.

The registered individual had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at the action plan that the registered individual had provided following the last inspection in 2016.

During the inspection we reviewed a variety of documents. These included examining five peoples care records, four staff recruitment files and information relating to supervisions, training and competency checks and file audits. We looked at the service’s policies, procedures and documents and other audits and checks completed by the service.

20 members of staff were employed at the time of the inspection. We spoke with the registered individual and other members of the management team including the two care co-ordinators when visiting the office. We spoke with three members of staff on day one, including the two senior carers, and spoke to a further two members of staff on the telephone on day three. We visited two people in their home and spoke with them about their experience of care. While we were there we also checked the records held within the person’s home with their permission. The expert by experience spoke with two people using the service and six relatives.

Updated 12 September 2018

Family Care Solutions is a domiciliary care service providing support for people living in their own homes who may need support with daily living tasks such as personal care. The service provides support primarily to older adults but also provides support to people with other needs. At the time of the inspection Family Care Solutions was delivering care packages to two children.

The provider of Family Care Solutions is a registered individual and this person was part of the management team. 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.

Not everyone using Family Care Solutions receives a regulated activity; 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. At the time of our inspection the service was supporting 55 people with a regulated activity.

The inspection took place on the 9, 10 and 16 July 2018 and was announced to ensure that somebody would be available in the office to help us during the inspection.

The service was previously inspected in June 2016 and at that time was rated good overall. The service was rated as being good in the four domains of effective, caring, responsive and well-led and rated as Requires Improvement in the Safe domain. This was because we found the provider to be in breach of Regulation 12 safe care and treatment, as the provider was not taking reasonably practicable steps to reduce risks in relation to moving and handling. The provider was also found to be in breach of Regulation 19 as safe systems of recruitment were not being effectively operated.

Following the last inspection, we asked the provider to complete an action plan to show how they would ensure they met the regulations. The action plan detailed the arrangements made to ensure the service was compliant with Regulation 12 through providing moving and handling training on an ongoing basis for all staff. The action plan also detailed how the provider would meet Regulation 19 through the introduction of candidate evaluation forms and pre-employment checks. At this inspection we found the service was no longer in breach of these Regulations.

Care records contained clear detailed information and risk assessments in relation to moving and handling and there were policies in place to underpin the training required for staff. This included annual manual handling refresher training.

Systems to support the safe recruitment of staff were in place. We saw references and Disclosure and Barring Service (DBS) checks were being completed before a member of staff began working for the service. The DBS identifies people who are barred from working with children and vulnerable adults and informs the service provider of any criminal convictions noted against the applicant. These checks should help to ensure people are protected from the risk of being supported by unsuitable staff.

The service was continually recruiting and was aware that this would enable greater consistency for people. This would ensure that people were supported by staff who knew them and their care needs well.

There were policies and procedures in place to safeguard people from harm. Staff were trained to identify different types of abuse and respond to safeguarding concerns.

Assessments of people were undertaken and used to develop peoples’ care plans and risk assessments. Individual risk assessments were in place and documented actions for staff to reduce identified risk and promote peoples’ safety. Generic safety risk assessments in relation to the other aspects, such as laundry and clinical waste, were also in place. Care plans and risk assessments were reviewed regularly, and amended when there were changes in people’s needs. People told us they were involved in reviews of their care needs.

We saw records that demonstrated staff received training, supervision and spot checks. However, we could not be certain that supervision and spot checks were undertaken consistently. Staff told us that they had the training and support they needed to do their role.

There were policies for infection control, health and safety and food hygiene and we saw that staff received training in these areas. Staff told us they had access to personal protective equipment (PPE) such as disposable gloves and aprons and people told us that staff generally wore PPE when providing personal care. This meant that people were protected from the risk of illness through good infection control practices.

We looked at how medicines were recorded and administered to people requiring support with this task. We found that people were supported safely to take their medicine. We spoke with the service about best practice guidance during the inspection.

We saw that care records considered issues of dignity, respect and consent and there were policies in place to underpin these practices. People told us that staff were respectful and maintained their privacy and dignity and that consent was requested.

People who were supported with food and drink had care records that were detailed about how this support was to be provided. Monitoring charts for food and fluid intake were used when appropriate to ensure people identified at risk of dehydration and malnutrition were receiving adequate amounts to eat and drink. People were supported to buy food from suitable sources, which fitted with their preferences and religious beliefs.

There was a complaints procedure in place and concerns and complaints were recorded. We could see that the registered individual addressed these with people. However not everybody we spoke with was clear how to complain.

The service had systems for governance in place.

The service had good links to other agencies and worked closely with people and services to enable them to deliver a tailored package of care.