Cera Cheshire

Updated 6 February 2019

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.

We gave the service 72 hours’ notice of the inspection visit because the manager is sometimes out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 10 January and ended on 11 January 2019. It included visits to people in their own homes. We visited the office location on 10 and 11 January to see the manager and office staff; and to review care records and policies and procedures.

This inspection was carried out by one adult social care inspector, one assistant inspector and one expert 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.

Before the inspection we checked the information we held about the service. We looked at any notifications received and reviewed any information received from the public. We also contacted the local authority to seek their views about the service. They told us they had no current concerns. The provider completed a Provider Information Return (PIR). 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.

During the inspection we spoke with eight people who used the service and four carers or relatives. We also visited two people at their homes. We spoke with several staff including the registered manager, the deputy manager, the operations director (Northwest) and five care staff.

We reviewed six people's care records, looked at three staff files and reviewed records relating to the management of medicines, training and how the registered persons monitored the quality of the service.

Updated 6 February 2019

This inspection took place on 10 and 11 January 2019 and was announced. The service was last inspected on 31 August and 1 and 5 September 2017. At that time, we found three breaches of regulations and the service was rated as requires improvement.

Following the last inspection, we met with the provider to confirm what they would do and by when to improve the key questions safe, responsive and well-led to at least good. At this inspection we found that improvements had been made and the provider was no longer in breach of the regulations. We have rated this service as good.

This service 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, younger disabled adults, children. There were 68 people using the service at the time of the inspection.

Not everyone using Homecare 4U Cheshire receives a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in place. 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.

People were positive about the support they received because they knew the carers well and told us they benefitted from consistent and familiar staff. There were sufficient staff and care calls were usually on time and rarely missed. The provider had implemented a new app which enabled staff to easily access the rotas and other important information.

Relevant checks continued to be completed before staff worked unsupervised at the service.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and who to report this to if required. Improvements had been made to risk assessments, which were undertaken and further action taken to mitigate risks where necessary.

Medicines were managed safely. Staff were trained and were supplied with personal protective equipment (PPE) such as gloves and aprons. We noted some minor recording issues relating to medicines, which the registered manager addressed straight away.

People's needs continued to be assessed before they started using the service and were reviewed to develop their care plans. People received appropriate support to meet their nutritional needs.

Staff had the appropriate skills and knowledge necessary to deliver effective care and support. Staff undertook an induction when they started with the service. They had ongoing supervision and appraisals to support their development.

Carers asked for people’s consent before providing any care. We found the service was working within the principles of The Mental Capacity Act 2005 (MCA).

People were supported to maintain their health and wellbeing through access to a range of community healthcare services and specialists. Where necessary staff contacted health care professionals to provide support.

People were positive about the approach and attitude of staff. They told us that overall, they received support from caring staff who knew them and their needs well. Staff respected people’s dignity and privacy.

People continued to be involved in decisions about their care and were involved in the development of their care plans. They were supported to make choices and staff respected their routines and preference.

The provider had taken action to improve care plans and had included further information which was person centred and contained details about people’s preferences, likes, interests and personal histories.

People received care and support that was personal to their needs and was responsive to their changing needs.

People knew how to raise a complaint. Everyone spoken with felt able to contact the management team with any concerns or issues and felt that appropriate action would be taken.

There was a complaints log in place, however, we recommend that the provider consider keeping a record of smaller issues that are raised, which may not be considered formal complaints, but require some action to be taken to improve service user satisfaction. This would further enhance the quality monitoring practices and support the provider to drive improvements.

People, their relatives and staff were positive about the way the service was managed. The service monitored and assessed the quality of the service they were providing to people. Improvements had been made since the last inspection. Care plans and risk assessments had been re-written to include information which was focused on a person-centred approach.

People's views were sought to help develop the service and action plans were in place for ongoing improvements.