Archived: Kare Plus Altrincham and Trafford

Kare Plus Altrincham and Trafford is a domiciliary care service providing personal care and the treatment of disease, disorder and injury to older people, younger adults, learning disabilities and autistic spectrum disorder and people living with dementia. 41 people were using the service at the time of the inspection.

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 were not always receiving timely visits from staff to support them at home. This was evident from the phone calls we undertook with people and their families and call logs. While the provider had identified this concern, people were still receiving support from staff up to an hour earlier or an hour later than scheduled. The variation between the times of calls also put people at risk of receiving their medicines without the required intervals. There was further evidence one person was not receiving a time specific medicine within the correct time frames. Some staff felt they were not given enough time to travel from one property to another which impacted upon the call times for people. Risks to people were assessed, monitored and reviewed. Staff were aware of safeguarding procedures and how to report any concerns.

The management team had identified where people had been receiving untimely calls and had tried to remedy the issue. We made a recommendation; the provider reviews all scheduled calls to ensure they are at people’s commissioned time and incorporate timely gaps between the calls if this is appropriate. We also recommended staff travel times are reviewed to ensure staff have enough travel time in-between each visit. Following the inspection, the provider instigated further processes to manage the rota more effectively. Audits were in place to monitor and improve the service and while some audits had identified shortfalls, concerns around the timeliness of medicines being administered had not been highlighted and rectified. People, their relatives and staff gave mixed responses on the support the provider gave.

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 6 April 2018).

Why we inspected We received concerns in relation to late and missed calls and inconsistency staff teams supporting people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We did not find any evidence of missed calls.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kare Plus Altrincham and Trafford on our website at www.cqc.org.uk.

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.

Kare Plus North Cheshire is registered with CQC to provide personal care and support to people living in their own home. At the time of our inspection 23 people were using the service and being supported in meeting their care needs.

Not everyone using Kare Plus North Cheshire received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection the service had appointed a new manager who was in the process of becoming a registered manager. 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 who used the service and their relatives were positive about the care they received. People we spoke with told us they felt well cared for and that staff knew them well. Comments we received included; “They are very friendly and caring.” and; “They’re caring and do everything I need.”

People told us they were encouraged to remain as independent as possible and had been involved in deciding how their care was being given. At the time of our inspection the manager was in the process of visiting every person using the service to review their care plans and agree new ones.

Care workers told us they felt supported and had noticed an improvement since the manager had been appointed. They told us the staff in the office were very approachable and they felt able to speak to them at any time if they had any concerns and had confidence the concerns would be dealt with appropriately.

The service owner and manager told us that they were committed to providing the best quality service they could. At the time of our inspection the manager was implementing new systems to monitor quality and evaluate where improvements could be made however it was too soon to see how effective the systems would be.

The service owner told us that employing the right staff was very important and they would not take new care packages on unless they had the right care workers in place to do it safely. He told us; “If I can’t see you looking after my parents then I’m not going to take you on.

Care workers underwent a through recruitment and training process and additional training was available which staff we encouraged to complete.

During our inspection we found a discrepancy in one care worker’s recruitment file. Although we were satisfied the recruitment process had been safe, the discrepancy should have been identified by management. We recommended the service review its sign-off process for new care workers.