The inspection took place on 21 November 2016. The inspection was announced. Homelife Care Limited Crowborough is registered as a domiciliary care agency, providing personal care to people in their own homes in the community. They provide services to any people who need care and support. The agency provides care services mainly to people living within a ten mile radius of their office in Crowborough. There were approximately 114 people receiving support to meet their personal care needs on the day we inspected.
There was a registered manager based at the service. 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 service was run by two providers who were fully involved in the day to day running of the service. The registered manager was also one of the providers.
People felt safe when receiving their support from Homelife Care Limited and knew who to contact if they had any worries about their safety. Staff had a good knowledge of how to safeguard vulnerable adults from abuse and knew what their responsibilities were within their role. They knew who to report their concerns to both inside and outside of the organisation.
Risks to individual people and their circumstances had been identified, with actions put in place to reduce the risk and maintain people’s safety. People’s home environment, inside and outside, had been checked for hazards before their support commenced, helping to keep people and staff safe. Most people did not need help from staff to take their medicines, as they managed this themselves or family and friends helped, however some people did. Staff had the training necessary to equip them with the skills to safely administer medicines to people.
The providers had robust recruitment processes in place to make sure new staff were suitable to work with vulnerable people in their own homes. Enough staff were available to be able to run an effective service, responsive to people’s needs. People told us that staff were always on time when visiting and always stayed to support them for the whole time they were allocated. Staff had suitable training at induction when they were new as well as regular updates. Most of the training was by DVD's although the registered manager allocated time on the rota for groups of staff to go into the office to undertake their training. Additional training was available to make sure staff were skilled and confident to cater for specialist needs, such as to support people living with dementia. Staff had ‘spot checks’ to make sure their practice continued to be safe and of good quality as well as one to one supervision.
Although most people looked after their own health care needs or had a family member who helped with this, staff supported people who needed assistance when requiring health care appointments or advice.
People told us they made their own decisions and choices and staff were clear that people were in control of their care and support. Mental capacity assessments had been undertaken where appropriate following the principles of the Mental Capacity Act 2005. People’s families were often involved if their loved ones needed support to make decisions and family members told us this.
The caring approach of staff was evidenced, people were very positive about the staff who supported them, some describing them as friends they looked forward to seeing. Most people had regular staff providing their care and support who had got to know them well, creating confidence and trust. People were given a service user guide at the commencement of their care and support with the information they would need about the service they should expect.
A member of the management team undertook an initial assessment of people’s personal care needs so the registered manager could be sure they had the resources available to support people. People had a care plan that detailed the individual support people required as a guide for staff. People, and their families if appropriate, were involved in the process to ensure the support in the care plan expressed how they wanted their care and support to be undertaken. Regular reviews of the care plan took place with the involvement of people and their family members.
How to make a complaint was included in the service user guide, and the people we spoke to knew how to make a complaint if they needed to. The provider asked people for their views of the service by asking them to complete a questionnaire once a year. The registered manager also checked that people were happy with their support when they regularly visited to undertake reviews.
All the people we spoke to and their relatives thought the service was well run. People and their relatives knew the provider and registered manager by name and were very complimentary about them both, saying they were happy to speak to them and always got a response.
Staff were happy with the support available for them and said that suggestions or concerns were responded to quickly. They found the registered manager and provider very approachable and would be happy to raise any concerns with them, confident they would be acted upon.
The provider had a quality monitoring system in place to make sure the service provided remained safe and of good quality. They were looking to improve their system to suit their needs better in order to ensure they were responsive to making necessary improvements in the future. A range of auditing processes were undertaken at various intervals. People were asked their views of the service and the registered manager acted on the feedback provided to improve the quality of support to people.