Archived: Age Concern York In Safe Hands Services

Age Concern York In Safe Hands Services is a domiciliary care service that can provide care and support to people living with dementia, learning disabilities or autistic spectrum disorder, mental health, older people and people with physical disabilities. The service provides support to the main carer, who looks after an adult at home, so that they can have a break from their caring role. They employ paid care staff and volunteers and support is usually two or four hourly visits weekly or fortnightly. Not everyone who used the service received personal care. The Care Quality Commission (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. At the time of the inspection the service was supporting 50 people. Eleven people were receiving regulated care.

People’s experience of using this service:

We received very positive views from people and their relatives about the support provided to them. Relatives told us that staff were kind and respectful.

Care and support was tailored to each person's needs and preferences. People and their relatives were fully involved in developing and updating their planned care. People were supported with activities and interests to suit them. Staff and volunteers spent time getting to know people and their likes and dislikes.

Recruitment checks were carried out to ensure staff were suitable to work in the service. Staff had received appropriate training and support to enable them to carry out their role.

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. We made a recommendation about best practice in relation to consent.

People received their medicines safely. The registered manager had positive links with health care professionals which promoted people’s wellbeing.

Relatives and staff told us the registered manager was approachable and listened to them when they had any concerns. All feedback was used to make continuous improvements to the service. The provider had systems in place to safeguard people from abuse and staff demonstrated an awareness of safety and how to minimise risks.

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 this service was Good (published 16 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Age Concern York - In Safe Hands is registered to provide personal care to people in their own homes. The agency employs paid care staff and volunteers. They can support people living with dementia, learning disabilities, mental health conditions, physical disabilities or sensory impairment. Some of their work is to provide support to the main carer who looks after an adult at home, so that they can have a break from their caring role. At the time of our inspection there were a mixture of paid care workers and volunteers working for In Safe Hands York service; volunteers provided a sitting service (staying with a person in their home whilst their carer went out or had a break), whilst care workers mainly supported people to access the community and/or activities. Support was typically provided to people for two to four hours during one weekly visit. At the time of our inspection, the service was supporting 60 people and was providing the registered activity of personal care for up to nine of those people.

The service was last inspected in September 2015. At that time, we found the service to be in breach of Regulation 12 Safe Care and Treatment and Regulation 17 Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered provider submitted an action plan with information to address those areas that were in breach. During this inspection we found that, the actions the registered provider had implemented because of our previous inspection meant they were no longer in breach of Regulation 12 or Regulation 17.

The registered provider is required to have a registered manager in post and on the day of our inspection, there was a manager registered with the Care Quality Commission (CQC). 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.

Care workers and volunteers we spoke with understood the types of abuse they might see and knew how to respond to protect people from avoidable harm and abuse. People’s needs were assessed and risk assessments put in place.

The service had a safe recruitment process and a system to ensure that they had sufficient care workers and volunteers to meet people’s needs. Pre-employment checks were completed before employees commenced their role which meant only those people considered suitable to work with vulnerable people were employed.

Systems and processes had been implemented that helped to ensure medicines for people were administered safely in line with policy and procedure. Medicines audits were completed monthly and where errors or omissions were recorded actions were implemented that help prevent re-occurrence.

Where accidents and incidents had been reported we found a system in place to record and evaluate the event and the registered manager signed these off to certify they had been dealt with and where appropriate corrective measures implemented.

Care workers and volunteers we spoke with told us they felt supported in their work and that advice and guidance was always available when needed. Training was managed electronically and this included areas the registered provider considered essential and other areas that were specific to people’s individual needs. This meant staff had the appropriate knowledge required to meet with people’s individual needs.

Staff and management understood the requirements of legislation under the Mental Capacity Act 2005 (MCA). Staff told us they always assumed people had capacity unless assessments identified otherwise. Staff encouraged people to make their own decisions. Where people had received an assessment for capacity this was documented along with any best interest decision. Further information was not always available where a best interest decision had been made. The registered manager told us the main carer and the local authority had this information and they were awaiting a copy of the outcome. People were involved in their care planning and we saw where people had capacity to do so they had signed their consent to the care and support along with the main carer and the registered provider.

People were matched to one care worker or volunteer and had long-term support from one person meaning that care workers and volunteers knew how best to support that person and this consistency helped people to develop meaningful caring relationship. People told us that care workers and volunteers treated them with dignity and respect and staff told us they understood how to maintain their confidentiality.

As part of quality assurance, the registered provider completed quarterly surveys to collect people’s views and telephoned people and staff to check on their service satisfaction. Staff completed reviews after each visit that identified any concerns. Feedback was evaluated and any concerns were promptly acted on which helped to improve the service people received.

Activities people enjoyed were documented and reviewed with the person and their families. Confirmation was provided that staff spent time with people and encouraged them to participate in their preferred activity and people told us they valued this important part of the support provided by staff.

People were protected from the risk of infection because staff had received training and guidance which helped to protect all parties.

There was enough skilled and experienced staff to meet people's needs. This was confirmed by people we spoke with who said the staff and volunteers had the skills and temperament they needed to undertake their role.

The quality of the service being provided was being monitored by the manager. Any issues found were being acted upon. This helped to ensure that people remained satisfied with the service they received. A person we spoke with said 'If needed, someone from the organisation is always available.'

People were made aware of the complaints system. People we spoke with confirmed they had made no complaints to make about any aspect of the service. They all said they would raise issues if they had any. One person said 'I would feel able to raise a complaint, but I have never needed too.'