Croft Care Services

Updated 3 October 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.

This inspection site visit took place on 17 July 2018 and was announced. We visited the office location to see the registered manager and office staff; and to review care records and policies and procedures. Following this we made telephone calls to people who use the service and/or their relatives, and spoke with care staff between 19 and 24 July 2018. The inspection team consisted of two adult social care inspectors who visited the office, an expert by experience who telephoned people using the service and an assistant inspector who made telephone calls to staff.

Before the inspection we requested a Provider Information Return (PIR) which was returned to us. 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 checked information held by the local authority safeguarding and commissioning teams in addition to other partner agencies and intelligence received by the Care Quality Commission.

We spoke with seven people using the service and three of their relatives. In addition, we spoke with eight staff including six care assistants, the registered manager and the provider.

We looked at seven care records including risk assessments in depth, three staff files including all training records, minutes of resident and staff meetings, complaints, safeguarding records, accident logs, medicine administration records and quality assurance documentation.

Updated 3 October 2018

Croft Care Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger adults living with disabilities. There were 167 people using the service at the time of inspection.

The inspection of Croft Care Services took place on 17 July 2018 at their offices and was followed by telephone calls to people using the service and care staff between 19 and 24 July 2018.The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

At our previous inspection in April 2017 we rated the service as ‘Requires Improvement’. We identified two regulatory breaches which related to safe care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions – safe, effective, responsive and well led, to at least good. This inspection was to check improvements had been made and to review the ratings.

There was a registered manager in post and available at the time of the inspection. 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.

We found improvements had been made in regard to risk management and medicines. Risk management plans were person-centred and contained information in relation to equipment and method, including pictorial guidance for staff to follow. Risk reduction measures were reflective of individual need. Medicines management was safe as staff were able to explain the process in detail and audits ensured effective oversight was in place.

People told us they felt safe with care staff, and we were confident staff knew how to recognise safeguarding concerns and what action to take in the event of having such a concern.

However, we did find some issues with call times from both the recipient and staff perspective. This was not across the whole service but some people felt staff were often late and problems only usually arose in the absence of their regular care assistant. This showed much of the care delivery was consistent but covering absence needed further consideration. Staff had a mixed experience where some felt their workload was appropriate but others felt rushed, with little time to travel between calls. Most staff told us they stayed the full duration of the call and analysis of call times confirmed this. We recommend the registered manager reviews the rotas to ensure staff have sufficient time to complete the required tasks and travel between calls.

The registered manager displayed a sound knowledge of current practice based on a number of sources and was keen to maintain this. This was enhanced by the provider who also took a pro-active approach to ensuring knowledge and policies were current.

Staff received an induction, supervision and training and people felt staff were confident in their duties. Staff felt their colleagues were supportive of each other.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had appropriate nutritional support and were supported to access other services as required if their needs changed. We saw some pro-active involvement by the service when one person’s mobility changed.

We found people spoke positively of the care staff, describing them as kind and friendly. There was evidence of some strong relationships between people and care assistants, and compliments we read reinforced this view.

People felt and were engaged in the process of designing and agreeing their support plans, and these were regularly reviewed to ensure they reflected current need. People told us their preferences were obtained and these were respected, such as with the gender of care staff.

Everyone told us their privacy and dignity were promoted.

Care records were accurate and reflected people’s needs, providing staff with an overview of the person’s needs. Daily records showed sufficient detail to evidence appropriate care delivery.

Complaints were handled with an apology, and full investigation of which the outcome was shared with the complainant. People knew who to approach if they had any issues and were confident they would be resolved.

The service had a registered manager who had developed the service and addressed the issues we found at the last inspection. The quality assurance systems meant records and people’s experiences were regularly evaluated and practice checked. The issue with call times was agreed for further consideration by the registered manager and provider to ensure service delivery was as robust as possible.