Archived: Care Services Thirsk Limited

Care Services Thirsk Limited is a domiciliary care service providing care and support to older people and younger adults, as well as people who may be living with a learning disabilities or autistic spectrum disorder, dementia, mental health needs, a physical disability or sensory impairment.

Not everyone using the service receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service

People received reliable and person-centred care from kind and caring staff.

Management focussed on assessing staff’s values through the recruitment process to make sure they were caring. New staff completed comprehensive shadowing and were introduced to the people they supported to learn how best to meet their needs. Staff understood people’s needs and provided person-centred care according to people’s likes, dislikes and personal preferences. People’s privacy and dignity were maintained.

People told us staff were on time, never missed a visit and they were supported by regular and familiar staff. People enjoyed staff’s company and had developed positive caring relationships with them.

People were kept safe by staff who were trained to identify and respond to any safeguarding concerns. People received safe support to take prescribed medicines and to make sure they ate and drank enough.

People were supported to seek medical attention if they were unwell or an accident or incident had occurred.

Staff listened to people, offered them choices and followed their instructions. 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.

Management were ‘hands on’ and closely monitored the quality and safety of the service. They were proactive in supporting staff. Staff told us management were approachable and very supportive. Supervisions and appraisals provided an opportunity for staff to reflect on their performance and identify goals for the future.

Management listened and responded to any complaints and were committed to continually learning, developing and improving the service. We recommended they review and develop record keeping in relation to accidents and incidents and to provide clearer evidence of how new staff had been assessed as competent.

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

Rating at last inspection

At the last inspection service was rated Good (report published 6 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 26 October 2016 and was announced. This was a comprehensive inspection which provided a new rating for the service.

At our last inspection on 11 September 2015 we found areas of practice that required improvement. These were in relation to a lack of robust recruitment checks, poor record keeping and a lack of formal training. Following the inspection the provider submitted an action plan which detailed the action they would take to make improvements.

At this inspection we found that the required improvements had been made.

There was a registered manager in post at the time of our 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.

People told us that they felt safe and were confident that staff understood their needs and how to support them safely. We saw a number of examples where the service had helped people when there had been a problem or incident at home. There were sufficient numbers of staff to provide the care and support that had been agreed. Care staff were confident about how to protect people from harm and knew what to do if they had any safeguarding concerns.

The provider had introduced robust recruitment procedures to make sure staff had the required skills and were of suitable character and experience.

Risks to people had been assessed and plans put in place to prevent avoidable harm. An ‘out of hours’ service was in place so that people could contact a member of staff when the office was closed. Medicines were managed safely and people were supported to take medicines as prescribed.

Staff were trained by management in how support each person individually. People told us that staff were skilled and provided the support they needed, often going beyond the expectations of the care package to provide assistance. Staff received the training and support they needed to carry out their roles effectively.

There was an up to date policy in place regarding the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager and care staff understood their responsibilities under this legislation.

People were provided with the support they needed to maintain their health and well-being. The provider had established good links with other professionals, such as doctors and district nurses. The service took positive steps to involve healthcare services when concerns were identified.

People told us that they received good care which supported them in the way they wanted. The feedback we received was entirely positive. People said that they were always involved and informed about any changes or developments. People’s dignity was promoted and care staff provided a personalised service.

The provider had made improvements to the care planning documentation. There were clear and up to date plans in place which reflected people’s current needs and preferences. These were regularly reviewed with the involvement of the people concerned and their relatives.

Record keeping had improved since the last inspection. This included daily records such as medicine charts, as well as records relating to the management of the service, such as recruitment.

The registered manager and nominated individual were open and receptive throughout the inspection. A nominated individual is a person who acts as the main point of contact with the CQC. A nominated individual has overall responsibility for supervising the management of the regulated activity, and ensuring the quality of the services provided. They had made improvements to the service since the last inspection. Their focus was on providing a tailored service to people which looked at all their needs rather than just personal care. People, their relatives and other professionals all told us that they felt the service was well-led and there was good management. Staff told us that there was a supportive working atmosphere and that their main aim was to provide a personal and caring service.