Crescent Office

Updated 10 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary care service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 7 October 2019 and ended on 10 October 2019 We visited the office location on 7 October 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and 11 relatives about their experience of the care provided. We spoke with seven members of staff including the nominated individual, registered manager and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 15 people’s care records and multiple medication records. We looked at seven staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We sought feedback from staff by email as there was not enough time to speak with them all in person. We received seven responses to our enquiries. The provider sent all requested information in a timely way.

Updated 10 December 2019

About the service

Crescent Office is a domiciliary care service providing personal care to 139 people at the time of the inspection. 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.

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

People and their relatives told us the service was safe, people were protected from the risk of abuse by staff trained in safeguarding who would not hesitate to alert the registered manager if they had any concerns. Risks were assessed, and controls put in place to minimise the risk of harm to people. Staff were safely recruited and there were usually enough staff deployed to meet people’s needs. Staff were trained to support people with their medicines and to ensure that the risks of infection were minimised.

People’s needs were holistically assessed, and care plans were person-centred with more detailed plans for people who were not able to tell care staff how they wanted their care delivered. Staff told us they felt supported and participated in one to one meetings with their line manager regularly and received regular training and updates. People were happy with the support they received with nutrition. The provider was able to support people with specialist dietary needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives told us that staff were kind and caring and they were involved in decisions about their care. They were supported to maintain their independence and staff treated them respectfully.

People told us they spoke with the registered manager before commencing a care package and that their care plans were regularly reviewed. Information was available to people in several different formats on request and the provider had met their responsibilities under the Accessible Information Standard. The provider supported a few people to access the community and several relatives told us they were grateful for the respite having a sitting service provided them with. There was a complaints procedure in place and people knew who they should complain to and if necessary would speak to the registered manager, however they had not had any reason to complain. End of life care planning needed to be more fully embedded into care planning.

People and their relatives thought the service was well-led and that the management team were approachable. The service provided was person centred and the registered manager and their team were committed to supporting people to achieve positive outcomes. Feedback was sought from people and their relatives which was mainly positive, negative comments were addressed when received. Good working relationships were in place with health and social care professionals,

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 requires improvement (published 18 September 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crescent Office on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.