About the service:

¿ Calderdale Care Home Limited is a domiciliary care service which provides personal care to adults with a range of support needs, including dementia and physical disability, in their own homes.

¿ The Care Quality commission (CQC) only inspects the service being received by people provided with ‘personal care’. Where they do we also take into account any wider social care provided.

¿ Calderdale Care Home was providing personal care to 77 people at the time of the inspection.

¿ People’s experience of using this service: People supported told us they felt safe with the staff that supported them. Staff had undertaken safeguarding training. Staff understood their role and responsibility to keep people safe from harm.

Recruitment procedures were thorough and robust, with clear evidence of the pre-employment checks which had been carried out.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿ People supported spoke fondly and with regard of the staff that provided support and the office team including the registered manager. People told us staff treated them with dignity and respect and were kind and caring to them.

¿ People received personalised support from staff who knew them well. Staff had built positive relationships with the people they cared for and supported. Staff supported people to retain their independence and to remain involved in planning and reviewing their care. This helped to ensure care was provided in accordance with people’s preferences.

¿ Staff worked closely with a range of community healthcare professionals to promote good outcomes for people. People, their relatives and staff could approach the management team if they had any concerns.

¿ The provider had a complaints procedure in place which explained how people could raise concerns. The service had acted appropriately on any concerns and complaints.

¿ The registered manager operated a more robust governance system which included the completion of several audits. These were to ensure the service was operating within the policies and procedures set by the provider.

¿ Rating at last inspection: At the last inspection the service was rated good overall (last report published July 2016).

¿ Why we inspected: This was a planned inspection based on the rating awarded at the last inspection.

¿ Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

We inspected Calderdale Home Care Limited on 28 July 2016. The registered manager was contacted the day prior to the inspection to advise them of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager can be available.

The last full inspection took place on 21 November 2013, when we found the service was meeting the regulations we looked at. A further inspection took place on 12 February 2014 because we had received information telling us complaints were not being taken seriously. We found the director of the company had fully investigated the concerns and responded appropriately to the complainant.

Calderdale Home Care Limited is a domiciliary care agency which provides care services to people in their own homes. On the day of our visit 95 people were receiving a personal care service. The agency can provide a service to adults, older people, people living with dementia and people with physical disabilities.

There was a registered manager in post. 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 told us they felt safe with the care they received. We found there were appropriate systems in place to protect people from risk of harm.

There were policies and procedures in place in relation to the Mental Capacity Act 2005..

We found that people were provided with care and support by staff who had the appropriate knowledge and training to meet their needs. Robust recruitment processes were in place and followed, with appropriate checks undertaken prior to staff working at the service. This included obtaining references from the person’s previous employer as well as checks to show staff were safe to work with vulnerable adults.

Staff had opportunities for on-going development and the registered manager ensured they received induction, supervision, annual appraisals and training relevant to their role.

The staff we spoke with were able to describe how individual people preferred their care and support delivered and the importance of treating people with respect in their own homes.

People using the service and relatives told us staff were caring and respectful of their privacy and dignity.

Care plans were in place and people and/or their relatives had been involved in developing these. Staff told us care plans were reviewed annually unless people’s needs changed in the interim. People had control over their care packages and some choose to pursue leisure opportunities supported by staff.

Medicines management systems were in place to ensure people received their medicines at the right times. When necessary staff involved district nurses, GP’s or the emergency services to make sure people’s health care needs were met.

People’s individual dietary needs and preferences were being planned for and met.

People had information about how to make a complaint and we saw complaints had been dealt with by the registered manager.

We found there were some effective auditing systems in place. However, the systems in place for checking staff had arrived at a visit were not robust and needed to be improved so any late calls could be picked up and arrangements made to cover.

People using the service were asked for their views every two months and annually through satisfaction surveys.

We received information about complaints and concerns not being investigated and responded to. We visited the service and found complaints were being taken seriously, investigated and responded to appropriately. We did not speak with people using the service as part of this visit.

We spoke with 15 people who used the service, seven relatives and five members of staff. The views of people using the service and relatives were very mixed. These were some of the things they told us:

“I have regular carers who turn up when they are supposed to and I am happy with the service.”

“My carers are very good and they know what they are doing.”

“At the moment we have an excellent group of carers who know my relative well and can recognise what they need. We have complained in the past and the response has been good.”

“The service is variable and depends on the staff as some are better than others. We would like a consistent group of staff so there is better continuity.”

“All of the carers my relative has are very good and always polite.”

“The carers that come are very caring and always have a chat.”

“They don’t always ring and tell me if the carer is going to be late.”

“My carers are brilliant.”

We found that care plans were in place that gave staff some direction about what they needed to do to meet people’s care and support needs. The care plans lacked detail about people’s personal preferences, routines and likes and dislikes.

There were systems in place to make sure that people were kept safe and procedures for reporting any suspected abuse.

Before stating work staff were being properly checked to make sure they were suitable and safe to work with adults at risk.

Staff we spoke with told us their training had been good and they felt supported in their role.

There was a complaints procedure in place and people told us they would feel able to raise any concerns. We saw complaints that had been made had been fully investigated.

We did not speak with people receiving care from this agency because we spoke with them at our last inspection on the 28th June 2012 and they told us they were happy with the quality of care. We set compliance actions at the last inspection on the 28th June 2012 because we were concerned about the quality of the care plans and lack of support towards care staff. At this inspection, we spoke with two care workers who told us they felt more supported. They told us they have attended training for their role, such as percutaneous endoscopic gastrostomy (PEG) feeding. The new manager showed us copies of four care plans which had been updated since our last inspection and told us that everyone would have a new updated care plan by the end of October. The new care plans we looked at were detailed and contained all the relevant risk assessments.There was evidence that people had been consulted about their care plan.

We spoke with five people who received a personal care service from Calderdale Homecare Service. They all said that they were happy with the care they received. They told us that the care staff were nice and involved them in making decisions about their personal care routine. However, one person did comment that they thought the new care workers were not as skilled as the more experienced care workers and regularly had to remind them how to conduct certain tasks. Four out of the five people whom we spoke with told us that they knew how to complain and would telephone the office if they had any concerns.

People who use the service did not make any specific comments about the essential standard we reviewed.

We spoke with three people who use the service and they told us they were happy with the care they receive and staff were very helpful and always explained what they were doing.

The people we spoke with told us they had been involved in a review of the care plans at least once within the last 12 months. They also told us that the care they receive is based on their needs and preferences.

The people we spoke with told us that they had no concerns about the care they receive. They told us that if they had any concerns or complaints, they would speak to the Manager.

The people we spoke with told us that they were generally happy with the care being provided. They also told us that staff were friendly and provided care based on their needs and preferences.

Two people we spoke with told us staff are occasionally late but this has not affected the care receive.

One person told us that the care they receive varies depending on the care staff. This person told us that although the staff are very friendly and pleasant; some of the staff are inconsistent when it comes to washing hands and wearing gloves when they prepare microwave meals.