Crofton Care Partnership

Crofton Care Partnership is a domiciliary care agency providing personal care to people. At the time of the inspection the service was supporting 70 people with regulated activity.

Not everyone who used the service received 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

The management of the service had a system in place to monitor and improve the service however there were areas were this was not fully robust and required improvement, for example in maintaining records. We gave feedback to the registered manager and general manager and this was taken on board. The general manager had taken steps during the inspection to improve this immediately. There was a positive culture within the service and the management were approachable. Staff felt well supported during their employment.

There were sufficient numbers of staff, who provided support within the thirty-minute window set by the provider. The service had undertaken appropriate recruitment checks on staff members to ensure staff were of good character. Staff understood their responsibilities around safeguarding. Medicine administration was managed appropriately but there were gaps in the records which were addressed during the inspection. Incidents and accidents were recorded and investigated.

Staff received training in a range of subjects that were appropriate to their role. People’s nutritional and hydration needs were met.

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.

We received positive feedback about the caring and compassionate approach of staff. Dignity and respect were always maintained and people were supported to remain as independent as possible.

Care visits were carried out on time. We received mixed feedback about the timeliness of calls however, the records of staff signing in and out of calls demonstrated that they arrived within thirty minutes of their scheduled time. Care records contained relevant information but would have benefitted from further details about people’s histories and preferences and around moving and handling requirements. People were confident to raise concerns with the management, though the service had not received any formal complaints.

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 7 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.

Crofton Care Partnership is a domiciliary care agency. They provide care and support to people, in their own homes, in the Fareham and Gosport area of Hampshire. On the day of the inspection the service provided care and support to 78 adults with a range of needs including those living with dementia and older people. They employed 26 care workers.

There was a registered manager at this 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.

There was clear leadership and management at this service. The registered manager and general manager were described as fair, easy to talk to and part of the team. They promoted the values of the service and we saw that they led by example. They had met their obligation to notify CQC of any events that affected the running of the service.

There was sufficient staff with appropriate skills and knowledge working at the time of the inspection to meet people’s needs. They were recruited safely. We saw that checks of their background had been completed and two references had been obtained to ensure that they were suitable to work with people who may be vulnerable.

Measures had been taken by staff to ensure that the security of people’s homes was maintained.

Risk assessments were completed for the environment to ensure the safety of people who used the service and staff.

Risks to people’s health were clearly identified. These were recorded in people’s records and there was clear guidance for staff about how to manage those risks. People’s medicines were managed safely.

Accidents and incidents were recorded and reviewed with appropriate actions taken to prevent any reoccurrence.

Staff received an induction and training which gave them the skills and knowledge required to carry out their role. They were supported through supervision and appraisal. They were clear about their roles.

The service had good links with Hampshire local authority. They attended a provider group with the council where they could share good practice.

The risk of infection was minimised because staff were provided with personal protective equipment such as gloves in order to carry out personal care.

A variety of methods of communication were used to ensure staff received information and were kept up to date. Staff carried their own telephones and the service sent them text message to update them about calls.

Staff were working within the principles of the Mental Capacity Act and sought people's consent before providing any personal care. When staff handled anyone's money it was with their consent or that of the person with lasting power of attorney for finance.

People received support from staff to make sure they received their meals. They had pre-prepared meals which staff heated for them. They made sure that people received drinks when that was required.

Staff were aware of peoples current healthcare needs. If someone required a visit from a GP staff would arrange that for them.

People told us that staff were caring, kind and friendly. We saw that staff were focused on the person and people mattered to them.

People were given information about the service and clear explanations about any care provision. They were involved in decisions about their care. They contributed to their care planning.

The care plans reflected people’s current needs with associated risk assessments. They were reviewed every six months unless changes were made before that when they would be reviewed.

Staff took care to maintain people’s privacy and dignity.

The service had a policy allowing 15 minutes either side of the planned call time. This allowed for any unplanned events. If staff were late someone else would carry out the call. People told us that staff stayed for the full time booked.

Complaints were dealt with in line with the service policy and procedure. People were encouraged to give feedback and the provider was proactive in asking people for their views.

The general manager was undertaking a research project looking at quality assurance within the service as part of their leadership and management training. There was a quality assurance system in place and the general manager felt that this could be an area which would benefit from further development.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe, caring, responsive, effective and well led?

This is a summary of what we found-

Is the service safe?

People told us they felt safe when staff visited them in their home. Staff supported people to take their medicines in a safe and effective way. People were cared for by people who had the appropriate skills and experience to ensure their care and welfare.

Is the service caring?

People told us they were supported by kind and attentive staff. Staff treated people as individuals and provided care which was in line with their agreed plan of care. People told us, whilst they were not always supported by the same person, staff were always caring. People's needs were supported in a calm, dignified and respectful way.

Is the service responsive?

People's needs were assessed and reviewed regularly to ensure their needs were met. People and their representatives were encouraged to participate in care planning and review. The service manager regularly visited people and their representatives to ensure their needs were being met. This meant that people were able to express their views of the care they received and have them acted upon.

Is the service effective?

We saw that people received care which was individualised and planned in line with their needs. People told us their visits were usually on time. The allocation of visits for staff was completed daily for each person and this meant people did not always know who would be visiting them on any given day; however this ensured all visits were completed and the service workload was fairly distributed.

Staff told us they felt had received appropriate training to meet the needs of people and that they were supported to learn new skills if they were required.

Is the service well-led?

Staff told us they received adequate support from the management. They were clear about their roles and understood the need to inform office staff of any concerns they or people using the service had. Records showed that staff had regular conversations with management and some staff had received one to one supervision sessions with management to ensure they were supported in the work place.

This meant that staff were supported in their roles to ensure the safety and welfare of people.

People we spoke with were satisfied with the care they received from the provider. A person said "I have always felt safe with them all (staff) and they always know what they need to do". Another person said "they are real carers, I feel at ease with them and safe, I trust them". We found that staff had a good understanding of people's needs and how to care for people safely. Some people told us they would prefer to see the same staff more frequently.

We found that the provider had procedures in place to safeguard people from the risk abuse and that they acted on their concerns to promote people's safety and welfare.

People told us they were satisfied with the provider's staff. However, we have asked the provider to make improvements to ensure staff are adequately supervised and appropriately trained to carry out their role effectively.

People told us they were asked for their views on the quality of the service they received and we found that the provider used monitoring systems and information to make improvements to the service.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work. We saw the following policies: Staff Recruitment, code of Conduct for Staff, Training and Development, Appraisal and Training.

We looked at three staff employment files. Each contained evidence that they had been interviewed, two references received, gaps in employment explained and Criminal Record Bureau (CRB) check in place before they started their employment. Provider may find it useful to note that CRB certificates should to be stored in line with national recommendations.

Staff we spoke to said they had a 'in depth' induction and training was always available when they asked for it. Another said that Crofton Care Partnership was the best company they had ever worked for.