Archived: St Christopher's Personal Care Services Ltd

At the last inspection of the service in August 2016, we rated the service good.

The service had a registered manager at the time of the inspection. 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 service provided end of life care to people in their own homes that enabled them to actualise their wishes and experience a comfortable, dignified and pain free death. People and their relatives spoke highly of the personalised service they received. Care plans were person-centred and focused on achieving the best possible outcomes for people and enabled people to achieve their wishes and promoted their preferences. The service adopted an individualised approach and focused on giving people positive experience and fulfilment. The service actively involved people and their relatives in planning their care and considered their views. They worked with a range of health and social care professionals to ensure people received timely and appropriate care and support. Staff were very experienced in delivering end of life care because they benefitted from comprehensive training and they were well supported to do this. Staff respected people’s dignity and knew to preserve the dignity of the dead in line with people’s cultural and religious beliefs. Relatives were given support in form of counselling and bereavement support groups to cope with their loss and bereavement. The service had a system in place to ensure they continued to receive the support they needed when they moved between services.

There was solid leadership and management. The service focussed on delivering a high quality, personalised service to people and enabling people to die as they wished. The person-centred approach and care people received was evident in all aspects of the service. Staff were passionate about their roles; they felt listened to, supported and empowered to develop their knowledge and skills. The service valued the views of people, their relatives and staff regarding the service provided. Regular feedback was obtained, and an annual survey was conducted to gather the views of those involved in the service. Actions were developed to addressed areas requiring improvement. The quality of the service was monitored closely through audits, checks and quality improvement meetings. The provider put steps in place to constantly improve quality. People received care and support from a team of health and social care professionals both within and outside the service. Staff liaised effectively with these professionals to ensure people’s symptoms and conditions were well managed. The provider worked in partnership with local and national agencies to develop best practice guidance and training on end-of-life care.

Staff were supported to undertake various training courses to improve their skills and knowledge in the job. Staff were also supported through reflective practice, group supervisions, and workshops. Staff had access to one-to-one counselling to help them cope with difficult deaths they might have experienced. There were enough numbers of experienced staff to support people. Staff recruited were vetted to ensure they were suitable to deliver care and support to people. Staff were trained to keep people safe from abuse.

Senior, qualified and experienced staff members carried out an assessment of people’s needs and risks. The service followed best practice guidelines in assessing people’s needs and risks. The likelihood of people experiencing avoidable harm was therefore reduced. People received their medicines from staff who were trained to do so in line with safe administration procedures. People were supported to maintain their nutrition and hydration. Incidents and accidents were reported by staff and these were reviewed by senior management and lessons shared with staff. Staff followed procedures to reduce the risk of infection.

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 support this practice. People consented to their care before it was delivered. People and their relatives were involved in making decisions about their care. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005.

People received care from staff who were compassionate and caring. Staff supported people to make day to day decisions about their care. People were encouraged to maintain their independence. People’s privacy was respected, and their dignity was promoted. Staff maintained positive relationships with people.

People’s care was delivered in a flexible manner and met their preferences and requirements. People knew how to complain if the wished. The registered manager investigated and addressed each complaint received about the service.

St Christopher’s Personal Care Services Limited is a domiciliary care agency that provides care and support for people at the end stages of life to enable them to continue to live independently in their own homes in South East London. At the time of this inspection 60 people were using the service.

The service had 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 and associated Regulations about how the service is run.

We found the service had appropriate safeguarding adults procedures in place and that staff had a clear understanding of these procedures. People using the service said they felt safe and that staff treated them with kindness and understanding. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

People had access to health care professionals when they needed them and were supported, where required, to take their medicines as prescribed by health care professionals. Staff had completed training specific to meet the needs of people using the service and they received regular supervision. The manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. People’s care files included assessments relating to their dietary and other essential support needs.

Assessments were undertaken to identify people’s support needs before they started using the service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken if necessary.

The registered manager was committed to continuous improvement and used a variety of methods to assess and monitor the quality of the service. These included annual satisfaction surveys, spot checks and care reviews. We found people were satisfied with the service they were receiving. The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.