Spring Cottages Home Care Limited

Spring Cottages Home Care Limited is a domiciliary care service providing personal care to older people, people living with a dementia or with a physical disability in their own homes. At the time of our inspection there were 53 people using the service.

People’s experience of using this service and what we found

Systems were in place to safeguard people and investigate allegations of abuse. Risks were assessed, management confirmed all people’s risk assessments would be checked to ensure they included detailed information about how to manage their needs. Staff were recruited safely, most staff confirmed they completed their choice of shift patterns. Staff told us there was sufficient staff in place.

Staff had undertaken training, supervisions and spot checks on staff performance was completed. People were happy with the skills of the staff team. Assessments of people’s needs had been undertaken, and were ongoing. People were supported with their meals when this was part of their care plan. Records included details of professionals.

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. Management confirmed they would take action to ensure all staff understood the Mental Capacity Act 2005.

All people, relatives and staff were complimentary about all of the management team. People’s views were sought and team meetings were taking place. A new electronic governance system was in place and being embedded. Audits and monitoring was completed. A range of policies, procedures and guidance was available to support the development and delivery of care of the staff team. Evidence of partnership working was noted.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 July 2023). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider ensured systems were in place to support the management of medicines and, to ensure checks on staff skills and supervisions were in place. At this inspection we found they had made improvements.

Why we inspected

At our last inspection we identified breaches of regulation in relation to good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Spring Cottages Home Care Limited 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.

Spring Cottages Home Care Limited is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection the service was supporting 54 people.

People’s experience of using this service and what we found

Not all individual risks had been reflected in people’s care plans. Accident records had no details of the action taken and did not confirm management had reviewed them. Care records for one person did not contain detailed information about the management of a medical condition. There was no record of completed competency checks for medicines administration.

People told us they felt safe, and staff had received safeguarding training. The registered manager told us they were waiting for outcomes from the local authority for ongoing investigations. Staff were recruited safely. An electronic system was in place for visits. PPE was available and staff had completed training. People were confident in the knowledge and skills of the staff team. Staff training had been provided. However, we made a recommendation in relation to regular spot checks, supervisions and ensuring records were completed that confirmed inductions for new staff had taken place. People’s needs had been assessed and there was evidence of professionals involved, where required.

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.

People were positive about the care they received, and they were treated with dignity and respect. Staff said good care was provided. Care plans were developed electronically, and people, relatives and staff had access to them via an app. People were supported with end-of-life care when required. People’s communication needs were recorded, and they were supported to access social activities and the community. Complaints had been dealt with, a system to record verbal feedback would be introduced immediately.

Audits were not being undertaken appropriately. The nominated individual took action to develop a detailed audit system. The provider had not identified the failings we noted prior to this inspection. People were positive about the registered manager and the staff team. People were engaged and involved. However, staff meetings had not been undertaken for some time. The service worked in partnership with others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 8 July 2019.

Why we inspected

We undertook this inspection as part of a review of the information we held about the service.

Enforcement and Recommendations

We have identified breaches in relation to records and good governance.

We have made recommendations in relation to ensuring systems were in place to support the management of medicines and ensuring checks on staff skills and supervisions were in place.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Spring Cottages Home Care Limited is a domiciliary care service providing care and support to people in their own homes. At the time of the inspection there were 101 people using the service. 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

People and their relatives told us they felt very safe. The provider had effective safeguarding procedures and staff felt confident raising concerns. We found an issue with the application forms and this was actioned immediately by the registered manager during the inspection. People told us their medicines were being managed safely and comprehensive assessments of need and care plans were undertaken.

Staff were skilled and had appropriate training. 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.

People told us the staff were extremely caring. They told us they were treated with dignity and respect. Staff we observed were kind, caring and compassionate. We saw numerous thank you cards and compliments praising the staff team and many people described them as wonderful. People and families felt listened to and felt confident raising any issues. We saw that where concerns had been raised, these had been actioned effectively.

People were regularly consulted about their care and received care that was centred on them as an individual. People felt well supported by the management. It was clear they were passionate about the person-centred care they provided as a family run agency.

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.

As the agency is small we gave 24 hours notice of our inspection. This was because the registered provider is actively involved in the day to day running of the agency and we needed to ensure they were available.

The office is based in Padiham with parking available. At the time of the inspection Spring Cottages Home Care Limited supported 80 people with care and support needs. An out of hours contact number is provided for use in the event of an emergency.

At the time of inspection there was a manager who was registered with the Care Quality Commission. 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 were systems in place to ensure people who used the service were protected from the risk of harm and abuse. Staff we spoke with knew the action to take if they had concerns in this area. They told us they would report concerns to ensure people were protected from harm.

Staff were knowledgeable of peoples’ assessed needs. People who received care and support and their relatives told us they were happy with the care provision from Spring Cottages Home Care Limited.

There were arrangements in place to ensure people received their medicines safely.

Recruitment checks were carried out prior to a staff member starting to work with the agency. Staff received training to enable them to give care that met peoples’ needs. Staffing was arranged to ensure people received care and support at the time they wanted.

There was a complaints policy, which was understood by staff and was available to people who received care and support. People told us they were confident any complaints would be addressed and they considered staff to be caring. We were told, “They’re gentle and kind to me.” And, “I can’t praise the staff enough. They’re all so nice and thoughtful as well.”

The management of Spring Cottages Home Care Limited demonstrated their understanding of the processes in place to protect people’s rights if people lacked mental capacity.

People who received care and support and staff, told us they considered Spring Cottages Home Care Limited to be well-led.

The manager told us that since out last inspection they had written to all clients who used the service who had medications included in their care package. A family member we spoke with confirmed they had received this information regarding planned changes from the provider. We were shown evidence of feedback from clients and relevant others and we discussed how the provider dealt with any concerns raised.

One client told us the support workers help with their medicines. They said, 'The staff always help with my medicines. They watch me take them. The staff go through my care file, I am confident my medicines are okay'.

We looked at six care records that were held at the service's office and records that were kept in the home of two people. We saw records in place to ensure people's consent was gained in relation to the personal care provided.

People told us they had no concerns about the care being provided and they felt safe and protected from potential harm. One person told us, 'They always make sure my mum is safe and well. We have their number in case of an emergency'.

We found improvements needed to be made to make sure medicines were always administered safely.

People told us their care workers provided sensitive and flexible support and they were well cared for. A person spoken with told us, 'The staff are brilliant' and 'If we didn't have them we'd be lost'. We looked at six staff records and saw evidence they had received supervision and were provided with training relevant to their role.

We found risk assessments that were required to be kept to protect the safety and wellbeing of people were accurate and up to date.

We noted that the agency policies and procedures were clear and up to date. These procedures are required to ensure good working practices and protect people who may be at risk.