Background to this inspection
Updated
2 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 17 July 2019 and ended on 19 July 2019. We visited the office location on 17 July 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with one person and two relatives about their experience of the care provided. We spoke with five staff members including the registered provider, the deputy manager, the administrator and two care workers.
We reviewed a range of records. This included two people’s care records in full and parts of two other people’s care records, including medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
2 October 2019
About the service
Angelwings Homecare is a service providing care and support to people in their own home. At the time of the inspection the service was providing support to 16 people. Not everyone who used the service received personal care; only four of these people were receiving 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 and staff spoke about the ‘Angelwings family’ and comments from people included: “A lovely bunch of people and my life would be completely different without them”, “As soon as they walk into our home they make you feel so special”, and “I’m treated like a normal person.”
The service was exceptional by placing people at the heart of the service and its values. It had a very strong person-centred approach. Staff and managers spoke passionately about the importance of the service’s ethos ‘Quality only happens when you care enough to do your best’ and told us how they provided person-centred care to people when they need it to improve the quality of their lives. People and their relatives all said they felt staff were like extended family. The deputy manager told us, “We don’t tell staff how to deliver quality care, we inspire them to do so.”
People’s needs and wishes were met by consistent staff who knew them well. We observed many examples of staff going ‘above and beyond’; for example, staff had noticed one person becoming more withdrawn and had suggested getting a pet for this person to care for. Following discussions and agreement with health professionals, staff had taken the person to choose a pet and this had significantly helped the person’s mental health.
People and their relatives told us they were treated with great respect for their privacy and dignity. There were examples of where staff had gone ‘the extra mile’; for example, one staff member had slept in the office when they were unable to get home after delivering care and the manager had provided a bed to support this, and one staff member had made an additional Christmas lunch and taken it to a person they support.
The service organised community and individual activities and considered the needs of everyone to ensure these were as inclusive as possible. For example, when planning a trip out which included a visit to a restaurant they planned different activities for people who were unable to eat. People received the same regular dedicated staff. People’s care plans were clearly written and detailed each step to ensure people received the care they had requested. Staff told us they had time to chat to people and the care they provided was not primarily task driven.
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.
The leadership and management team were praised by people and staff for their commitment and passion for the care profession. The service was committed to recruiting the best quality staff and understanding and treating them with understanding and respect. Regular staff meetings took place; these always included a buffet. Staff told us about the positive culture throughout the service and how they constantly looked to learn from each other. Staff explained how proud they were when they were stopped by members of the community whilst wearing their uniform and told they had heard how good the company was.
Thorough and regular audits were carried out and action on any discrepancies was clearly identified and recorded. People were asked their views in person and through quality surveys. These were analysed and thoughtful consideration was given to making improvements. The service took every opportunity to learn and improve.
Staff were recruited safely. They were well-trained and were supported and encouraged to undertake additional training in areas which would better support the people they cared for, as well as for their own personal development. There was always a manager on-call and people felt comfortable to ring at any time for support, for example, when they were accessing the community independently and needed additional support. Staff were very aware of how to report any concerns and were wholeheartedly confident managers would respond appropriately. Staff told us they were very well supported by managers. Managers told us, “We aim to be person centred for staff as well as people.”
People were supported safely and risks regarding their care were assessed on an individual basis and actions thoughtfully considered to mitigate risks in the best interests of the person. People who received their medicines from staff did so safely. People’s food and drink was monitored, when needed; records showed this was detailed and information included the calorific and fat content of foods regularly eaten so this could be monitored accurately.
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 19 December 2016).
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.