Carers and Companions Ltd

Carers and Companions Ltd is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older people, people with dementia, people with a physical disability, people with a learning disability and autistic people. At the time of our inspection there were 13 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

The provider assessed risks to people and demonstrated safety was always effectively managed.

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.

Staff received appropriate training which equipped them with the right skills and knowledge to deliver safe, person-centred care. Safe recruitment processes were in place.

People were usually supported to receive their medicines safely.

Right Care:

Care was personalised and responsive to people’s needs.

People who used the service and their relatives were very happy with the service and confirmed they were involved in planning their care.

Feedback about the management team and staff was consistently positive.

People received support from staff who were reliable, arrived on time and stayed the agreed period.

Right Culture:

The service was consistently well-led. The management team promoted high quality care and monitored practice against the service’s vision and values.

Staff were proud to work at Carers and Companions Ltd.

Effective systems were in place for engaging with people who used the service, their relatives and staff. The service had received many compliments which evidenced people received person-centred care.

Staff and management worked in partnership with other professionals.

During the inspection we identified a small number of areas to improve such as recording the administration of some medicines and formalising staff supervision arrangements. The registered manager was very responsive and took immediate action to address these issues.

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 22 December 2017).

Why we inspected

We inspected due to the length of time since the last inspection.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Carers and Companions Ltd on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The inspection took place between 7 and 20 October 2017 and was announced.

At this inspection we found the service remained Good overall. We rated the ‘Is the service caring?’ domain as outstanding. This is because evidence from people, relatives and health professionals demonstrated the service was exceptionally caring and staff had ‘gone the extra mile’ to assist people in feeling comfortable and ensure they were well cared for.

Without exception people said staff were kind and caring. Staff and the registered manager demonstrated excellent caring values and were committed to a highly person centred approach, providing companionship as well as care and support. Staff, people and health professionals were able to give examples where they had gone out of their way to support people, undertaking tasks and checks in their own time to make people feel comfortable and ensure their welfare. The service listened to people and made positive changes to the service based on their views.

A registered manager was in place. 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 said they felt safe and secure using the service. Risks to people’s health and been assessed and staff had a good understanding of how to keep people safe. Staff understood how to identify and report safeguarding concerns. We saw concerns were taken seriously by the manager and acted upon to keep people safe. Safe systems of medicines management were in place. There were enough staff deployed with suitable experience and qualifications to keep people safe.

People said staff provided effective care and support. Staff knew people very well and had received a range of high quality and interactive training based on their individual needs and requirements. Staff supported people effectively to eat and stay hydrated. The service worked well with a range of external health professionals to ensure people’s healthcare needs were met. These professionals spoke positively about the service.

People’s care needs were met. Care plans were in place which provided a good level of detail about people’s needs and preferences. The timeliness of the service was good. People reported staff arrived on time each day and the service was very reliable. Staff stayed with people for the allocated call time and completed all care and support tasks.

People, relatives and staff all said the service was well run. The registered manager listened to people and acted on their comments, complaints or suggestions for improvements. A range of audits and checks were undertaken to help assess, monitor and improve the service.

Arrangements were now in place to ensure the safe management of medication, which appeared sustainable. The provider had recently updated its policy to make the processes for the management of medication more robust. Clear and detailed risk assessments were in place with regards to each person's medication needs. A clear record of the medications each person was supported with was maintained.

We found staff treated people with dignity and respect, promoted people to be independent and involved them in their plan of care.

We found people received appropriate care and welfare from the provider and staff understood their individual care needs.

However, we found people were not protected against the risks associated with medicines because the provider did not have robust arrangements in place to record the administration of medicines.

We found staff were provided with appropriate support in order to undertake their role.

We found the provider had suitable arrangements in place to monitor the quality of its service provision through feedback mechanisms from people who used the service and its staff.