This is our second visit to Chapter Care Ltd in 2011. Our first visit was a responsive review in August 2011 in response to a concern about an individual person, which resulted in two meetings with a range of professionals and a member of the management team from the agency. In our first inspection we focussed on specific standards that linked to the concern. After this inspection, the agency was required to produce an action plan as all seven standards that we had inspected were not compliant with the Health and Social Care Act 2008 (HSCA).
We returned on 23, 25 and 29 November 2011 to carry out a planned, unannounced inspection, which included essential standards under the HSCA to check on improvements. The purpose of our second inspection was to check for improvement against the action plan that Chapter Care Ltd had supplied. On this visit, we also looked at the standard for safeguarding because of information we saw during our office visit, which raised concerns about how the agency responded to safeguarding issues. After our second inspection the Care Quality Commission (CQC) held a management review meeting to help us decide what actions we would take because of this concern. We have requested that the company meet with us in January 2012.
What people told us and experienced
This second inspection took place over three days; one day was spent in the office during which we met with staff and looked at the agency's records. This part of the inspection was unannounced. We were given a list of 77 people who used the service and we chose a random group of people to speak with in order to gather their views on the service. On the second day, we rang a range of people with different care needs who used the agency. We spoke by phone with five people who used the service, and we also spoke with two relatives and one private care worker. On the third day, we met with three people in their own homes, and with two relatives. We then requested further information from the agency, which was supplied by 9 December 2011.
We asked eight people about the reliability of the service. One person told us that there had been one recent missed visit. The other seven people said that the service was very reliable.
Most people's experience was that care staff were generally on time, and if they were not, they were informed by office staff that there would be a delay. For some people, punctuality was particularly important as they were dependent on care staff helping them out of bed or getting ready to attend a social activity.
We asked people about their views regarding the attitude of staff who supported them in their own home. People's responses were very positive about the staff members' professionalism and caring attitude. People made comments such as they are 'good girls', while another said that the male care workers that supported them were 'fantastic'. This person said these care workers used their initiative and did not need to be asked twice to provide help. A third person said 'they treat me well' and a fourth person said they could not fault the care staff. A fifth person described the care workers as being 'professionals'.
Most people told us that staff never breached confidentiality and they were not told about the needs of other people that the care workers supported. However, confidentiality could become blurred when two people who both received a service from Chapter Care knew each other. For example, one person told us a care staff member had told them an acquaintance had been unwell. They considered that the care worker had done the right thing.
We asked eight people if care staff knew how to provide the care they needed. They all confirmed that care staff knew what to do and how they liked their care to be provided. One person said that occasionally staff would check with them but generally this was not necessary. People said they were treated as individuals, and one person said that staff knew exactly how they liked their cup of tea made, which was important as they could not perform this task.
Eight people told us about or showed us their care plans, which were kept in their home. This was a brief care plan about the type of the support they needed. Most people said they did not bother to read it as they had no problems with the care provided.
We spoke with thirteen people who either used the service, or were relatives of people who used the service or were a private care worker. They all told us that Chapter Care staff were helpful, professional and knew what to do.
We asked eight people whether staff administered their medication, helped them with eye drops or applied prescribed creams. Five people told us they managed their own medication or a relative helped them. One person did not have any medication and another could not answer this question. The final person said that a care worker had met with their district nurse in order to learn where and how to apply their prescribed cream. They told us that the instructions for application had been written accurately in their care plan, and staff were competent in this task.
We spoke with thirteen people who either used the service, or were relatives of people who used the service or were a private care worker. None of them raised concerns about the suitability of staff.
We spoke with thirteen people who either used the service, or were relatives of people who used the service or were a private care worker. None of them raised concerns about the skills of staff. People told us that staff knew what to do.
We asked eight people if they knew how to make a complaint about the care they received. Eight people told us that there were numbers they could ring to contact the office on the front of their care plans and people told us they would be confident that the issue would be addressed by the agency. Most people said they had no reason to complain. One person expressed unhappiness with the attitude of one staff member in the office, but most people expressed satisfaction with how they were treated and said office staff were helpful.