Care Remedies Ltd

Care Remedies Limited is a domiciliary care agency. The agency provides personal care to people living in their own homes. At the time of the inspection, care was being provided to 57 people. Some were living with dementia, some had physical disabilities and two had learning disabilities.

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.

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

People told us they felt safe and this was supported by relatives and carers. Staff had a good understanding of safeguarding and what steps they would take if they had concerns. Risk assessments had been completed and were bespoke to individuals. Accidents and incidents were correctly reported, recorded and investigated. Staff were recruited safely, and people were supported with medication when necessary.

A robust induction process was in place which was followed up by regular training, supervision, meetings and appraisals. Staff knew people well and knew how to communicate with them. Some people were supported with food and drink and management of diabetes. Food and fluid intake records were kept where there was concern. Staff understood the importance of gaining consent from people and all staff had received mental capacity training.

Staff were seen to be kind and caring towards people in their own homes. People’s differences were recognised and celebrated, and people had choice about how their care and support needs were met. People’s privacy and dignity were respected. People were encouraged to be as independent as possible with daily tasks such as washing, dressing, food and drink preparation.

Care was delivered in a person-centred way. People were supported to attend medical appointments when family/carers were not available. Staff helped people out on short trips to the seafront and to an annual pantomime at certain times of the year. At the time of the inspection no one had significant communication needs but the staff had received training in communication and aids were available to help if the need arose. A complaints policy was in place and was accessible to everyone. Few complaints had been raised and all issues had been dealt with quickly and satisfactorily. No one using the service was in receipt of end of life care but staff had received training in this area.

People, relatives and staff spoke well of the registered manager who provided clear, visible leadership and support. Although there was no formal meeting structure there were various ways that people, relatives and staff could provide feedback. Annual questionnaires were completed and then analysed by the registered manager. The service was relatively small and regular interactions took place with the management. The new computer system meant that audits could be carried out daily for medicines, accidents and incidents with a fuller monthly audit to identify trends carried out by the registered manager. The service is growing and there are ambitions to expand further. The registered manager told us that they wanted to ensure the new computer system was fully imbedded before further growth.

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, (report published 14 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.

Care Remedies is a family run, domiciliary care service providing support to 24 people living in their own homes who are in receipt of the regulated activity of personal care. The service supports older people and people who are living with dementia or other conditions, to enable them to continue living in their own homes. Some people privately funded their care whilst others had their care funded by the local authority. The service is based in Eastbourne, East Sussex. .

The service was owned by two providers, one of which was the registered manager. 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 they felt safe. One person told us, “They’re always careful with me I’ve never been hurt”. Another person told us, “Oh yes I can trust them, there has never been any mishaps”. Staff had received induction training and had access to on-going training to ensure their knowledge was current and that they had the relevant skills to meet peoples’ needs. People were safeguarded from harm. Staff had received training in safeguarding adults at risk, they were aware of the policies and procedures in place in relation to safeguarding and knew how to raise concerns.

There were sufficient staff to meet peoples’ needs and people told us that they were cared for by kind and caring staff. One person told us, “Very nice, helpful, I like them all. I’ve had them a long time”. People confirmed that they were treated with respect and dignity and their privacy maintained. One person told us “They cover me with a towel, always clean up after themselves and leave everything tidy”. Another person told us, “Always respectful, always nice, they don’t treat you like an old person”.

Risk assessments had been undertaken and were regularly reviewed. They considered peoples’ physical and cognitive needs as well as hazards in the environment and provided guidance to staff in relation to how to support people safely. There were low incidences of accidents and incidents, those that had occurred had been recorded and were used to inform practice. People received their medicines on time, they were administered by staff that had undertaken relevant training and who had their competence assessed. People had access to relevant health professionals to maintain good health. People were supported with their hydration and nutrition and were offered support according to their needs and preferences.

Staff had undertaken essential training as well as training that was specific to peoples’ needs and conditions. People felt that the staff were well trained and felt confident that they had the right skills to meet their needs. One person told us, “I’ve every confidence in them, no problems”. People told us they were asked for their consent before being supported. For example, when being supported with their personal hygiene or to take medicine. The providers and staff understood that people should be supported to make their own decisions, and when people had difficulty with this, had involved the relevant people to ensure any decisions made were in the person’s best interests. People were involved in their care and decisions that related to this. People were asked their preferences when they first joined the service and these were respected and accommodated. Regular reviews ensured that peoples’ care was current and appropriate for their needs.

There was a warm and friendly atmosphere within the service. People were complementary about the leadership and management. One member of staff told us, “Best company I’ve ever worked for, I’m supported, I’m really happy”. Staff felt supported by the providers and were able to develop in their roles. Quality assurance processes were carried out to ensure that the quality of care provided, as well as the environment itself, was meeting the needs of people. The providers had good systems and processes in place to ensure that the service people received was effective.

People told us that they were asked for their consent before staff provided personal care. One person said, "Staff always ask if I need help before they do anything, they are very good.'

We looked at the care planning system and found that the records showed the care and support people wanted and needed. People told us that they were treated with respect and that staff were very courteous. One person said, "I am very happy with the support I receive.''

We looked at the medication policies and procedures. We found that appropriate systems were in place and regular audits were completed, which ensured people were assisted with medication safely.

We looked at recruitment procedures. Relevant checks and training was completed before new employees provided support.

A complaints procedure was in place. People were aware of this and told us they did not have any complaints at the time of the inspection.