Archived: Flexicare South Midlands

Flexi Care South Midlands is registered to provide personal care to younger and older people, as well as people who have a mental health illness, physical disability, sensory Impairment or a learning disability. Care and support was provided to people at prearranged times who lived in their own home. At the time of this inspection visit, Flexi Care South Midlands supported 31 people who received a regulated activity. Care calls ranged from 30 minutes to one hour in duration. Four people received care 24 hours of the day, seven days a week.

People's experience of using this service and what we found

People and relatives spoke positively about the service they or their relative received. People and their family members said they felt safe when staff supported them and their support for most of the time, was provided by a consistent staff team. People who received 24/7 support, had the same staff stay with them for several weeks to ensure continuity of care was maintained.

People told us staff for the most part, arrived on time and stayed for the agreed required time to support them. However, some people said they were not always informed if staff would arrive later than planned however, they all said their calls were completed. The manager agreed to follow this up with staff.

People were safe because staff were recruited safely. Staff and the provider knew how to keep people safe and protected from abusive practice by referring to the relevant agencies. Staff received training to help them meet people’s needs and when people’s needs changed, staff responded to those needs. For people who had complex health conditions, staff were trained so they knew how to care for them to meet their needs.

Staff followed infection control procedures in line with national guidance for reducing the spread of COVID-19 and other infections. People and relatives said staff wore PPE throughout their care calls.

People’s plans of care were detailed and accurate for staff to provide safe care. Reviews were completed to ensure staff continued to provide consistent care.

Risks related to people’s care were recorded and where required, risks were specific to certain people’s health or individual circumstances. There were instructions for staff to follow to manage those identified risks and people’s plans of care were personalised.

Staff’s knowledge of how to support people was consistent with people’s care records and what people told us. Care calls were managed well and staff were matched to people’s preferences, such as gender choices being respected.

People and relatives were complimentary about the management of the service. The quality and safety of the service people received was monitored by the provider and through increased checks recently introduced by a new manager to the service. The manager and staff said they worked well as a team.

The service does not currently have a registered manager in post which is a condition of registration. The provider confirmed an application for the current manager at the service to become registered with us had begun.

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

Rating at last inspection and update

The last rating for this service was good (published 12 December 2019). You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Flexi Care South Midlands our website at www.cqc.org.uk.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels. A decision was made for us to inspect and examine those risks.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has stayed the same. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Flexicare South Midlands is a domiciliary care agency providing personal care to people in their own homes. This includes people living with dementia, physical and learning disabilities, autistic spectrum disorder, mental health needs, sensory impairment, younger and older adults. The service provides daily care visits and, ‘live in’ care. 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. At the time of inspection, the service was providing personal care to 35 people.

People’s experience of using this service and what we found

People told us they felt safe with the support they received from staff and their care was provided by regular care workers. People did not feel rushed during their care and knew who to speak to if they wanted to complain or raise a concern. Most people gave us positive feedback about the service and felt comfortable raising concerns knowing they would be dealt with.

People said staff had enough time to get to know them and treated them with kindness, respect and dignity. People told us that staff were well trained. The registered manager and director had a clear set of values about the care people have a right to receive which they based on compassion, consideration and dignity. The feedback we got from people echoed these values.

Staff understood their responsibilities about safeguarding people from abuse and took measures to manage infection control. Training and development was valued and promoted amongst the staff team, and feedback from staff about their training and ongoing support was positive. There was a positive working culture and everyone we spoke to was happy working for this service.

We found some issues relating to the management of certain medication which the registered manager responded to promptly and kept us informed of progress in response to this. We also found some events had not been reported to us. These were made retrospectively following the inspection visit. In response to these issues we have advised the registered manager to review guidelines in relation to the administration of certain medication and telling CQC of certain events and incidents.

People were involved in planning their care and told us the care they receive was what they wanted, based on their needs, preferences and changes in circumstance. Carer staff were responsive to people’s health and wellbeing and found the management team quick to respond to any issues identified with the people they support. People’s wider needs were understood and recognised; Positive partnership working with other agencies and professionals meant people were supported to achieve their desired outcomes. One person described the impact of the care provided to them as “life changing.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 9 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

This inspection visit took place on the 10 May 2017 and was announced. The provider was given 48 hours’ notice because we needed to be sure managers and staff would be available to meet with us. At the last inspection, the service was rated good. At this inspection we found the service remained Good.

There was a registered manager in post. 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.

The registered manager continued to have oversight of the service and to send us statutory notifications about important events at the service, in accordance with the regulations. They had delegated the day-to-day management of the service to a manager, who we refer to as ‘the manager’ throughout the report.

Staff understood their responsibilities to protect people from the risk of abuse. The registered manager checked staff’s suitability for their role before they started working at the service and made sure there were enough staff to support people safely. Staff were trained in managing and administering medicines safely.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks. People were supported to maintain as much independence as possible by being involved in planning their care.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported to eat and drink according to their preferences and needs. Staff supported people to maintain their health and to obtain advice from healthcare professionals when needed.

The manager and staff understood people’s individual needs and preferences for care and support. Staff knew people well, cared for them as individuals and respected their privacy and promoted their dignity.

People had confidence in the manager’s willingness and ability to deal promptly and effectively with any concerns or issues they raised.

The provider employed staff and managers who shared their purpose and values, which put people at the heart of the service. The management team checked the quality of the service by observing staff’s practice and asking people for their views of the service.

Further information is in the detailed findings below.

We found that people's needs had been assessed and care plans had been developed based on their needs, helping to ensure people received appropriate care. Risks had been identified and measures put in place to minimise risks to people who used the service.

People who used the service told us that care workers were respectful and polite and they felt safe with them. We found that care workers were knowledgeable about the needs of the people who used the service, received training and felt supported in their roles.

We found that the service was well managed and people told us that they were very good at responding to any concerns.

Staff we spoke with told us they enjoyed working for Flexicare. One member of care staff said, 'The other staff are really helpful, really good, there's always someone there for support.' Another member of care staff told us, 'It is very open here, you can speak your mind. There is nothing to improve, it's a good company to work for.'

The care plans we looked at were detailed and included clear instructions for staff. Care was planned according to people's abilities and identified risks to people health and well being. Care and support was delivered in a way that supported people to maintain as much independence as possible.

The provider took steps to minimise risks to people and staff. Confidential records were up-to-date and kept securely.