This announced comprehensive inspection was undertaken on 7, 11 and 12 January 2016. We gave the service 48 hours’ notice of our inspection.
Cambridgeshire Care Agency Limited is a small domiciliary care agency registered to provide personal care to people in their own homes. There were four people being supported with the regulated activity of personal care at the time of our inspection.
There was a registered manager in place during this 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. No one being supported by the service lacked the mental capacity to make day-to-day decisions. Staff demonstrated to us that they respected people’s choices about how they would like to be supported. However, not all staff were able to demonstrate a sufficiently robust understanding of MCA. The lack of understanding increased the risk that any decisions made on people's behalf by staff would not be in their best interest and as least restrictive as possible.
Plans were put in place to reduce people’s identified risks, to enable people to live as safe and independent a life as possible. Arrangements were in place to ensure that people were prompted with their prescribed medication when needed. Accurate records of staff supporting people with their prescribed medication were kept.
People were supported by staff in a respectful and caring way. Individualised support and care plans were in place which recorded people’s care and support needs. These plans prompted staff on any assistance a person may have required.
People, when needed, were assisted to access a range of external health care professionals and were assisted to maintain their health and well-being. Where required, staff supported people to maintain their links with the local community to promote social inclusion. People’s health and nutritional needs were met.
People were able to raise any concerns or suggestions that they had with the registered manager and staff and they felt listened to. Communication between people and the office staff/ management was good.
There were pre-employment safety checks in place to ensure that all new staff were deemed suitable to work with the people they supported. There were enough staff available to meet people’s care and support needs. Staff understood their responsibility to report any concerns about poor care practice.
Staff were trained to provide care which met people’s individual care and support needs. Staff were assisted with their training needs by the registered manager to maintain and develop their skills. The standard of staff members’ work performance was reviewed by the registered manager through supervisions, appraisals and spot checks. This was to ensure that staff were competent and confident to deliver the care and support required.
The registered manager sought feedback about the quality of the service provided from people who used the service. Staff were notified of any updates and changes to the service via e-mail communication. Quality monitoring processes to review and identify areas of improvement required within the service were in place. However, these audits did not always identify all areas of improvement needed regarding records held.