27, 28 August 2014
During an inspection in response to concerns
The staff were able to share with us their knowledge, practice and understanding of safeguarding people. Two relatives told us that they felt their [family member] was safe.
Staff we spoke with had completed their safeguarding training. The supervisor had completed the teach the trainer course. This qualified them to teach members of staff about the practice and procedures in safeguarding adults within the community setting. The updates maintained, enhanced and reflected current safeguarding practices to ensure that the risk of harm to people was minimised.
Is the service effective?
People's needs were assessed and personal care and support were planned and delivered in line with their individual care plan. We saw evidence that detailed assessments of people's individual care needs had been completed by qualified members of staff. People had copies of their care plans in their home when we visited and had access to their care documents.
People thought the care plans were an accurate reflection of their needs and the care that had been agreed. One person told us they had received support from the district nurse who visited them once per week. We saw the care notes to confirm that medical support was provided.
Is the service caring?
We saw some members of staff demonstrated respect and compassion when providing care and treatment and support in a person's own home. We found that some members of staff showed a caring manner and others we found to be rushed and impatient. There were inconsistencies in the manner people were approached and in the provision of care.
We witnessed one member of staff being caring towards a person in their home. We listened to how they communicated with them when they enquired about their welfare. The member of staff told us 'How I love my job'. We explored the response further to be told, 'I enjoy giving care and attention to people who are unable to fend for themselves'. The person receiving care spoke favourably about the care worker.
Is the service responsive?
The care plans we saw were detailed, personalised and contained sufficient information about the support people needed, such as personal hygiene, mobility and communication. We saw an example that support was planned in ways which encouraged people to maintain their independence.
We listened to a phone call of one person feeling very unwell and had to cancel the agency visit. The agency was responsive and arranged a doctor to make a home visit in order to provide medical support.
Is the service well-led?
The service had a management structure which consisted of an operations manager who oversaw all the operations and delivery of the agency. We saw that the business managers took the lead at each branch or location.
We were introduced to the community business managers, who concentrated solely on accumulating business from within the community. They formulated people's care packages and assessed people's needs. Care managers role was to handle concerns with care packages. The administrators were responsible for the daily phone calls and the entire administrative requirements of the office.
We saw that there were results of previous spot checks and they showed positive outcomes for the people who used the service. We reviewed several feedback comments from people who use the service their relatives and representatives. We had listened to the mixed reviews from people and their representatives regarding the care and support provided by this agency.
People told us that they were satisfied with the service provision. However half the people we had spoken with were dissatisfied with the care, treatment and support from the agency. One person had provided written feedback which stated 'I never see the rota and never know who is coming". The operations manager told us they had addressed this person's concerns and discussed with us that they would reinstate the rota system for people.
Relatives and the people who use the service disclosed how dissatisfied they were with the care provision of the agency. The operations manager told us that they will address the concerns raised which included the manner of care workers and the provision of the service.
We saw that the agency's documentation was in order however their customer satisfaction was lacking. People said that the care they received was inadequate. This coincided with the information we had received from a third party. They highlighted that the documentation and recording of care records were not always accurate.
The relatives we spoke with confirmed this and the manner in which care was provided added to people's dissatisfaction. We saw there were instances where the start time and the end time were incorrect. This was only the case for those families or individuals who were increasingly reliant upon the agency for their personal care. Those families who were more independent found the service provision helpful and made no complaints.