The service had put a system in place to monitor that staff to make sure they did not work more than their entitled hours as specified by the UK Border Agency.
We looked at staff and people's personal records and found that they were accurate and fit for purpose. To ensure this happened we found that the service had introduced checklists for staff and people's personal records to check they contained the correct information.
Appropriate arrangements were in place in for the safe handling, administration and recording of medicines. However, some people who used the service and their relatives told us that their carers did not always arrive on time and medication had been delayed or not given as a result of this.
An appropriate recruitment policy and associated procedures were in place. However, there were concerns regarding some employee's current immigration status and/or right to work. There was no process in place to monitor these issues.
People who used the service told us that they would be able to tell someone if they were unhappy about the way care staff treated them. Most people felt confident that their care worker knew what they were doing and all felt safe with their care worker.
We looked at people's care records and found that some of these contained insufficient and/or conflicting information. Staff we spoke with were able to explain the care needs of each person: they assured us that reviews of care and concerns raised had been followed through but there was not always a written audit trail to demonstrate this had taken place.
We used telephone interviews and home visits to people who use the service and to their main carers (a relative) to gain views about the service. We visited four people in their home and spoke with 18 people who received a service from this agency over the telephone.
People we spoke to felt safe with the carer workers who supported them. One person told us 'I feel very safe and the carers I have had appear to be very trustworthy.'
Everyone we spoke to said they or their relative were treated with dignity and respect by their care worker. People told us care workers understood their needs and respected their right to privacy. One person told us, 'they give me lots of privacy when washing me and discuss with me what clothes I would like them to fetch me to wear that day."
People we spoke to knew about their care plan and said that it was a good reflection of the care they received and needed.