Caring Comes 1st Ltd

Updated 7 May 2022

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 was carried out by one inspector and an 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.

Service and service type

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

Registered Manager

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

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

Inspection activity started on 20 April 2022 and ended on 22 April 2022. We visited the location’s office on 20 April 2022.

What we did before the inspection

Before the inspection we reviewed information we had received about the service since the last inspection at the previous premises. We reviewed CQC notifications. These describe events that happen in the service that the provider is legally required to tell us about.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and eight relatives about their experience of the care provided. We received feedback from four professionals who work with the service. We spoke with eight members of staff, including the registered manager. Their comments have been incorporated into this report.

We looked at a range of records relating to the management of the service. This included two people’s care records and medication records. We looked at four staff files in relation to recruitment and staff support. We read records relating to the management of the service, including policies and procedures and audits.

We considered all this information to help us to make a judgement about the service.

Updated 7 May 2022

About the service

Caring Comes 1st Ltd is a domiciliary care agency. It provides support and personal care to people living in their own homes. The service provides support to adults who have a range of physical, sensory or mental health needs. At the time of the inspection, 32 people were receiving personal care from the service.

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 were kept safe from avoidable harm because staff knew them, had received training and knew when they should act. The service worked well with other agencies to safeguard people.

People's needs were assessed before they were supported by the service. Assessments were available to staff and included information about risks and how these should be managed to help keep people safe. People’s medicines were managed and administered safely by trained staff, and clear records were kept.

People and their relatives were involved in assessment, developing plans and reviews. Staff routinely read records and updates to ensure they provided support which continued to meet people’s needs and preferences.

There were enough staff to meet people’s needs, and new packages of care would only be taken on if there were enough skilled staff to provide safe, high quality support. Safe recruitment practices were in place.

Staff had the skills and knowledge required to provide effective support. Staff completed induction and core training as well as more advanced courses to provide a service which reflected best practice.

Staff understood the importance of giving people choice and control where possible. They responded to people’s needs and wishes and treated them as individuals. People and their relatives were supported to express their views and be actively involved in making decisions about the support they received.

People and their relatives felt able to raise concerns. The service treated concerns and complaints seriously, investigated them and learned lessons from the results. Learning was shared to improve the service.

The registered manager and staff were clear about the responsibilities of their roles. The management team worked directly with people and led by example. Managers apologised to people and their relatives when things went wrong.

Governance processes were effective and monitored performance, kept people safe and provided good quality support. Actions were taken when shortfalls were identified.

People and their relatives were positive about the support they received. Professionals praised staff and the service they delivered. Staff felt supported and valued by senior staff and managers. They were proud to work for the organisation.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service at the previous premises was good, published on 15 January 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caring Comes 1st Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.