Sussex Grange Home Care

Sussex Grange Home Care provides personal care to 43 people in their own homes. They ranged in age from 59 to 99 years and had needs regarding physical health care and mental health needs This included those who were living with dementia.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the previous inspection we served a requirement notice regarding the care plans for people as they did not contain sufficient information and guidance for staff to follow. The provider sent us an action plan of how this was to be addressed. At this inspection we found care plans included clear details regarding the procedures for providing personal care. This requirement and regulation are now met.

People told us they felt safe with the care workers. Care workers had a good awareness of safeguarding procedures and knew what to do if they had concerns about people’s safety or well-being.

Risks to people were assessed and there was guidance in care plans so that care workers were able to mitigate these.

Sufficient numbers of staff were provided so that people’s care needs were met. People said they received a reliable service and that staff arrived on time.

People received their medicines safely.

Care workers were trained in infection control and hygiene. People and their relatives confirmed care workers followed procedures to prevent the spread of infection.

Care workers were well trained and knowledgeable about relevant care matters. A range of training courses were provided including access to nationally recognised qualifications in care. The provider supported care workers to develop their skills and knowledge and to recognise good practice.

People were) supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible. The policies and systems in the service support this practise.

People received care from staff who demonstrated the provider’s values of kindness, respect, treating people as individuals, and, that people mattered. There were examples of care workers going over and beyond their role to ensure people were treated well and their quality of life enhanced.

The provider had introduced a system whereby care records were accessed by care workers, and, people if they wished, on an IT system. Care workers accessed this on smart phones. This enhanced the access to information for staff and people and allowed the provider to monitor care was being provided as agreed with people.

The provider excelled in providing a service which went above and beyond what was agreed with people. This included supporting people to access the community and social groups facilitated by the provider. This helped reduce the social isolation of people.

The provider had an effective complaints procedure.

Whilst there were no people in receipt of end of life care the provider had policies and procedures for this as well as access to staff who were experienced in this.

The culture of the service was open and transparent. People and their relatives felt able to raise any issues or concerns. The provider worked well with other agencies to ensure care needs were met and information regarding current care procedures was updated.

Sussex Grange Home Care provides personal care to 50 people in their own homes. They ranged in age from 46 to 101 years.

The service had a 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.

Whilst each person had a care plan these were not in sufficient detail to show how care workers should meet people’s needs and how people preferred to be helped.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said the staff provided safe care.

Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to prevent any risk of harm.

Sufficient numbers of staff were provided so people’s care needs were safely met. Each person was provided with a schedule of care appointments which included the names of staff and the agreed times they would be providing care and support.

People received their medicines safely.

Staff were well trained and supervised and had had access to a range of relevant training courses, including nationally recognised qualifications.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005. The service had policies and procedures regarding the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s consent to care was sought and the registered manager and staff were aware of the principles of this legislation.

People were supported with the preparation of meals where this was needed.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed.

Staff had positive working relationships with people. Staff acknowledged people’s rights to privacy and choice. People told us how staff treated them with kindness with comments such as, “They are like my friends. I do have different carers but it’s like a rota system and I know them all. They are kind and respectful. ‘They respect my privacy and dignity more so than I do. They always listen to me.”

The service had a complaints procedure, and people said any concerns or queries were responded to.

People and their relatives’ views were sought as part of the service’s quality assurance process.

There were a number of systems for checking the safety and effectiveness of the service such as regular audits.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

They confirmed they were happy with the care and support that had been provided. One person told us, 'The service is excellent. The care workers are thorough, very kind, thoughtful and very caring.' Another person commented, 'I don't think they can be bettered. I don't know what I would do without them!' A third person said, 'I have been very impressed. The caring is far beyond what I thought it would be.' A relative told us, 'I think they are very good, because my family member is looked after very well.'

We spoke with two care workers by telephone. They demonstrated that they had a good understanding of their roles and responsibilities. They were also knowledgeable about the individual needs of each person they visited to provide care.

We also gathered evidence of people's experiences of the service by looking at a selection of records. They included care records, staff recruitment records and records of audits conducted by representatives of the provider. We found that the records we looked at were up to date and well maintained. They also ensured people received care that was safe, appropriate and in accordance with individual wishes and needs.

People experienced care, treatment and support that met their needs and protected their rights.

Records that we looked at showed us that staff had received a majority of the mandatory training. However we did not see that staff had received mental capacity act training. Mental capacity act assessments had been completed by social services this showed us that peoples mental capacity act assessments had not been reassessed.

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Records that we looked at showed us that people were able to make their own choices.

Records that we looked at showed us that people, their representatives and families were happy with the quality of service that people received. People that we spoke to told us that staff were great carers and very helpful. Feedback from questionnaires we looked at showed us that the provider had been delivering a quality service for people. However we did not see that the provider had enough quality assurance systems in place to adequately monitor quality within the service for example Risk assessments and policies and procedures had not been reviewed.