This inspection took place on 23 June 2016 and was announced. Family Care Solutions provide care and support to people living in their own homes. At the time of our inspection, the service was supporting primarily older adults living within areas of Stockport and Cheshire. The service was providing support to 58 people at the time of our inspection. The service was not required to have a registered manager. The provider was an individual who had responsibility for the day to day management of the service.
We last inspected the service on 27 January 2014 when the service was registered at a different address. At that time, we found the service was meeting the standards of the regulations inspected. At this inspection, we identified two breaches of the regulations, which were in relation to safe recruitment procedures and taking measures to reduce potential risks. You can see what action we told the provider to take at the back of this report. We made three recommendations, which were in relation to developing systems to monitor the safety and quality of the service, ensuring policies are up to date and recording of complaints.
People spoke positively about the service they received from Family Care Solutions. They told us the service was reliable and friendly and that staff were good. Staff told us they worked with the same people on a consistent basis and this was confirmed by the people we spoke with.
Staff, including managers were able to demonstrate that they knew people very well. We found staff and managers spoke about people in a kind, caring and respectful way.
There were sufficient numbers of staff to ensure all calls could be covered. We received one report of a missed call, however we were told this was not a regular occurrence. People told us staff turned up on time, or that there were only short delays, which could be due to traffic or staff being delayed on the previous call.
There was a generic, pre-populated risk assessment in people’s care files. These had not been personalised to individuals, so it was not clear that full consideration to potential risks had been given. However, we did see that where specific risks had been identified, such as in relation to self-neglect or behaviour that challenged, that additional risk assessments had been put in place.
Staff had received training in a variety of areas including infection control, safeguarding and the Mental Capacity Act. However, there was no recorded practical training in moving and handling and there were not always clear instructions in the care plan for staff to follow in relation to how to hoist people safely. Staff received an induction and were able to shadow more experienced staff until they felt confident prior to starting to lone-work.
People had care plans in place and there was evidence these had been reviewed and updated when required. There was no evidence of regular reviews if no required change had been identified. However, the provider had recently introduced a new electronic care management system, and we saw this had started to be used to help monitor and record when reviews were due or had taken place.
Staff told us they felt well supported and able to approach a manager with any concerns. They spoke highly of the quality of the service Family Care Solutions provided people.
People told us they would be confident to raise a complaint if they felt this was necessary. People we spoke with who told us they had made complaints said that any issues had been resolved quickly and to their satisfaction. The provider had not recorded informal complaints, so it was not possible to see what actions had been taken. They told us they had never received a formal complaint.
We saw staff had had a criminal records check before they started work. However, there were some gaps in records which would help the provider demonstrate that staff’s suitability for the role had been given due consideration. One staff member who had started shadowing other staff had started before references had been received and another staff file did not document the reasons for a gap in their employment history. We also found minutes from interviews had not been retained.
Staff demonstrated a good understanding of how to support people’s independence whilst balancing this against any potential risks. People told us staff always asked for their consent before providing care and were respectful of their privacy and dignity.
We saw the provider had researched good practice and sought advice from a professional in relation to providing effective support to meet a person’s needs. This had been used to produce guidance for staff.
There were some systems in place to help the provider monitor the quality and safety of the service. These were basic however and we have recommended the provider further develops these systems.
People, staff and the provider all talked about the benefits of the agency being small and local. For instance, we were told if someone rang the office, they would be talking with ‘the boss’ and they would work quickly to resolve any issues.