Crediton Care Services Limited

Crediton Care Services Limited is a domiciliary care service supporting adults in the community who require personal care in the Crediton area. 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 there were 20 people using the service who received personal care.

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

People told us they felt safe with staff, however the provider had failed to operate effective safeguarding procedures and escalate concerns in line with their policy. Recruitment processes were not consistently in line with legal requirements. This placed people at risk.

The governance systems in operation at the service had not identified that policy and legal requirements had not been followed evidencing they were not fully effective.

People had care plans in place and the people and relatives we spoke with told us the care provided to them met their needs. We identified that care records required further development to support staff in managing known risks and identify when escalation may be required.

There were sufficient staff to meet people’s needs. The provider was currently experiencing staffing challenges and as a result has returned some care packages. At the time of our inspection Crediton Care Services Limited was not taking on any further packages. People told us they received the required level of support with their medicines and told us staff supported them whilst wearing appropriate personal protective equipment.

People commented very positively on the caring nature of staff and the support they received. People said they were involved in choices and decisions regarding their care and support and that their independence was promoted. A person we spoke with told us, “They are excellent. They are conversational, kind and caring. They have built a good liaison with me. They respect me as a person.”

Without exception, every person and relative we spoke with told us they would recommend the service to others. Staff told us they were happy in their jobs and were keen to make a positive difference in people’s lives. There was positive feedback from people, relatives and staff about the provider.

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

Rating at last inspection and update

The last rating for this service was Good (published 26 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service and the elapsed time since the service was last inspected.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding, recruitment and good governance.

You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Crediton Care Services Limited provides personal care and support to people who may be living with physical or sensory impairments or dementia and are living in their own homes in Crediton and the surrounding areas. At the time of our inspection there were 52 people receiving a service.

This inspection took place on 1, 3 and 11 August 2017.

There was 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.

The service was exceptionally caring. People received support from caring, committed and compassionate staff. A strong caring ethos was promoted by the registered manager and company director, which ensured the staff team kept people at the heart of the service. Staff sought ways to improve people’s lives and people using the service said staff frequently went over and above to assist them and ensure they were happy and safe. Comments included, “I find them excellent. The staff are very nice, caring people. I look forward to their visits”; “They (staff) are like part of the family…they make it easy and take away the worry” and “Although I am alone, I am not alone with them (staff)…” People described how the service had been essential in reducing the risk of social isolation.

There were sufficient numbers of staff employed to provide people with their planned service. People were supported by a stable, skilled and caring team, who knew each person well and provided continuity of care for them. People said they were safe using the service because it was reliable, staff were well trained and caring. Comments included, ““This is a service I can rely on…” and “I feel safe with the girls; they treat me well…” Missed visits were rare; there had been two missed visits due to a rostering error in the past 12 months.

Staff were knowledgeable in relation to safeguarding people from abuse and they knew how to keep people safe from avoidable harm. Risks to individuals had been identified and there was guidance for staff on how to keep people safe. Where people were assisted with their medicines this was managed safely. There was an effective recruitment and selection process in place and the necessary relevant checks had been obtained before new staff started to work alone.

People’s right to make decisions for themselves was respected and staff sought consent when delivering care and support. People were supported to ensure they had a sufficient amount of food and fluid to promote their wellbeing. People received support from staff who understood and responded to their health needs.

People’s needs had been assessed before their care commenced. People and their relatives (where appropriate) confirmed they had been involved in creating and updating their care plans. All felt involved in making decisions about the care and support they needed. One person described the “partnership” of care that had formed, ensuring they were fully involved in their care and support.

People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues.

The provider had some systems for monitoring the quality of the service provided, but these were not always formally documented to evidence actions taken. However the provider was embedding the processes and making improvements to strengthen their systems.