Cheshire Homecare Services Limited

Cheshire Homecare Services Ltd is a large domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection the registered provider was providing support to 101 people.

At the last inspection, which took place in August, 2015 the service was ‘Good’.

At this inspection we found the service remained ‘Good’ and continued to meet all of the essential standards.

There was a registered manager at the time of the 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.

During this inspection we reviewed care plans and risk assessments. Care plans were detailed, consistent and contained up to date information. Risk assessments were regularly reviewed and were updated accordingly.

Medication management systems were in place. Medication was only administered by staff who had received the appropriate training. Regular medication audits were taking place and people received all medication which was prescribed to them.

The registered provider operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People who were receiving support from the registered provider provided ‘consent’ to receive care and support and were not being unlawfully restricted.

Recruitment processes were safely and effectively managed. The necessary recruitment checks had been completed, suitable references had been sought and Disclosure and Barring System checks (DBS) were in place for all staff.

Staff training, learning and development opportunities were reviewed during the inspection. Staff expressed that they were supported in their roles and had completed the necessary training in order to effectively carry out their roles.

We reviewed how people’s nutrition and hydration was supported. Staff were familiar with peoples’ preferences and people's likes and dislikes were well known amongst the staff team.

There was a formal complaints policy in place. At the time of the inspection there were no complaints being investigated.

We reviewed ‘Safeguarding’ and ‘whistleblowing’ procedures that the registered provider had in place. Staff explained their understanding of what ‘safeguarding’ and ‘whistleblowing’ meant and the actions they would take if they were presented with any concerns.

People and relatives we spoke with during the inspection all provided us with positive feedback about the quality and standard of care being provided.

Health and safety processes and procedures were reviewed. Audit tools and checks were regularly being completed and the standard and quality of care was being monitored and regularly assessed.

We found on this visit that the provider now ensured that people using the service were protected from harm. We also found that the provider had ensured that the service was fully monitored and assessed enabling people to have confidence in them. We found the service compliant with other outcome areas.

For this inspection we involved an expert by experience. The expert spoke with fifteen people. They commented:

'I rate them between good and excellent. I would definitely recommend them'.

'I've had no problem with them at all'.

'I would certainly recommend them'

'I really feel it's working ok'.

'They help me live in my home'.

'They are very good yes, they're really ok.'

'They are very good. I've used them for over a year, and its better now I really know the staff'.

'It's marvellous'.

'I've used them for a few years'and they are really helpful'.

'I rate it as excellent'.

'The cover provided by the service is excellent'.'

'My relative's recovery back home was rapid; we put this down to Cheshire home Care'.

'We they would recommend the service and they were between good and excellent in our opinion'.

We spoke to people using the service and their relatives about if their support needs were met. Everyone we spoke with said they had what they needed. One relative said, 'All (family member's) needs are met, without the service they would not be able to live independently in their own home.'

The service was working with people with differing needs. Some people who used the service had dementia and may have needed support due to a lack of capacity. The service had not developed a capacity policy or any routes for assessment when people lacked capacity. This was also the case where people may lack the capacity in the future. The Manager acknowledged this was a training need and had taken steps to address this by the end of the inspection.

Two of the people we spoke with said that the service could help out at short notice if they required extra support. One person said, 'I have used a lot of companies over the years and Cheshire Home Care are the most reliable one I've found.'

Management were not doing any monthly audits of the procedures used to protect both the staff and the people using the service.