This inspection visit took place on 13 December 2016 and was announced. This was the services first inspection since its re- registration with the Care Quality Commission (CQC) on 10 November 2016. This was because the service had moved premises.
Clifton Homecare is a domiciliary care agency, providing personal care to people in their own homes. The agency provides support in the home for older people and people who live with dementia. The agency operates from offices based on Orchard Road in St. Annes. At the time of our inspection visit Clifton Homecare provided services to 36 people.
The registered provider was an individual who also managed the service on a day to day basis. Registered providers 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 supported by the service consistently told us staff who visited them were polite, reliable, caring and professional in their approach to their work. They spoke positively about the quality of service provided and how the registered provider and her staff went the extra mile to ensure their needs were met. Comments received included, “The staff who visit me are of the highest quality. I am receiving the best care I could have wished. They are all lovely people and I cannot wait for their visits, they make my day.” And, “All my carers are polite and friendly always laughing and joking. They provide a fantastic service and nothing is too much trouble for them.”
The service was extremely responsive to supporting people outside their contracted hours. We were repeatedly told of occasions where the service had gone above and beyond what was expected of them. This included attending to one person who was being cared for at end of life who had been stranded due to recent floods in a rural area. With the use of the services 4x4 vehicle they had been able to get to the persons home and provide much needed care and food provisions. The carer of the person couldn’t praise and thank the registered provider and her staff enough for responding to their difficult circumstances.
People spoken with consistently referred to the registered provider and her staff as kind and caring people. They told us they valued their relationships with the staff who supported them and the support provided often exceeded what they had requested.
People supported by the service consistently told us they felt safe with the staff who supported them. They told us they received patient and safe care and they liked the staff who supported them. They said staff were respectful, friendly and conscientious.
People’s care and support was planned proactively and in partnership with them. People felt consulted and listened to about how their care would be delivered.
Links with health and social care professionals were excellent. Health professionals we spoke with repeatedly praised the standard of care provided and described the service as exceptional.
People were supported by the service to attend healthcare appointments to ensure their health and wellbeing was maintained. One person said, “They come and pick me up in their company car and support me when I have health appointments. I don’t know how I would get there without them.”
People who used the service were supported to attend outings organised by the service or activities of their choice with the services own transport. On the day of our inspection visit a number of people were attending a local garden centre for afternoon tea and cakes. People spoken with told us they enjoyed these events as they provided them with the opportunity to socialise and make friends.
The service had regularly organised fund raising events including two recent Macmillan coffee mornings. These had been attended by people presently using the service and family members of previous clients. The events had provided people with a good opportunity to socialise with each other, reducing social isolation and loneliness. Some people had exchanged email addresses and regularly communicated with each other.
The service managed safeguarding concerns, accidents and incidents promptly and investigations undertaken had been thorough.
The registered provider understood the requirements of the Mental Capacity Act 2005 (MCA). This meant they were working within the law to support people who may lack capacity to make their own decisions.
Recruitment procedures were safe with appropriate checks undertaken. Careful consideration had been given to ensure staff offered employment shared the same values and beliefs of the registered provider to deliver high quality care alongside the existing staff team.
Staff and their mix of skills were used innovatively to give them the time to develop positive and meaningful relationships with people to keep them safe and meet their needs. There was a strong emphasis on promoting independence and empowering people wherever possible.
Staff retention was good and people told us they were supported by staff who knew and consistently met their needs.
The service used innovative and creative ways to train and develop their staff and ensured they put their learning into practice to provide an outstanding service.
There was an emphasis on developing staff potential within a positive learning environment to create a high functioning service. Staff were encouraged to become champions in their field of interest including dementia care and safeguarding vulnerable people.
Staff were aware of the need to promote and maintain people’s safety whilst taking a person centred approach to risk. This enabled people to take calculated risks which enhanced their well-being.
Staff managed medicines consistently and safely. People told us they received their medicines at the times they needed them and they were happy with the support they received.
There was a strong emphasis on the importance to support people to eat and drink well. Staff were aware of people’s individual preferences and had the skills, knowledge and ability to meet their dietary requirements.
People were actively encouraged to give their views and raise a concern or to make a complaint. Information from investigations and compliments had been used effectively to drive quality across the service.
Leadership within the organisation was strong and there was a strong emphasis on continually striving to improve. The service actively sought and listened to the views of people supported by the service and acted promptly where areas of improvement were identified.
The registered provider had a clear vision of what was required of a quality service and this was evident from the feedback we received from people supported by the service.