About the service:

Conan Room is a domiciliary care service which provides personal care to adults with a range of support needs, 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.

Conan Room was providing personal care to 38 people at the time of the inspection.

People’s experience of using this service:

People supported by the service and their relatives consistently told us the registered manager and staff who supported them were pleasant, reliable, caring and professional in their approach to their work. They spoke positively about the quality of service provided. One person told us, “The staff are friendly, helpful and very professional. They genuinely care and chat with me about how I am and how my family are. I am very satisfied, they are respectful.” One relative told us, “I have absolutely no complaints. The staff can’t do enough for [relative], they are excellent, nice and kind I wouldn’t change anything.”

Staff had a good understanding in how to protect people from harm, and recognised different types of abuse and how to report it. Potential risks to people had been identified and people had been involved with decisions in how to reduce the risk of harm to them.

There were enough staff employed to keep people safe and meet their needs. Staff retention was good and people told us they were supported by staff who knew them and consistently met their needs. Staffing levels were continuously reviewed to ensure there were enough staff to provide flexible and responsive care.

People's medicines were managed in a safe way. Safe practice was carried out to reduce the risk of infection.

People's care and support had been planned proactively and in partnership with them. People felt

consulted and listened to about how their care would be delivered. 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.

Staff knew people well and supported them in line with their current needs and wishes. Staff were knowledgeable about people’s likes and dislikes and personal preferences. This helped people and staff to engage in meaningful conversations and develop strong relationships.

People and their relatives felt able to raise complaints and were confident that appropriate actions would be taken to address their concerns.

The registered manager used a variety of methods to assess and monitor the quality of the service. This meant areas identified for improvement through the quality monitoring processes could be actioned in a timely manner.

More information is in the full report

Rating at last inspection:

Requires improvement (report published on 21 March 2018).

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.

We undertook an announced inspection of The Conan Room on 14 and 19 February 2018. We gave the registered manager short notice that we would be coming because the location provides a domiciliary care service and we wanted to ensure the registered manager was available.

The Conan Room is a domiciliary care service that provides personal care to people living in their own houses and flats in the community. It provides a service to older adults in the Doncaster area.

This was The Conan Rooms first inspection since they moved location from Sheffield and re-registered with the Care Quality Commission (CQC) in March 2017.

The service had 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.

Overall people told us they were very happy with the service. They felt they were well cared for and that staff were well trained and dedicated.

People were very satisfied and told us they mainly had the same (or small team) of regular care workers. Nobody had any concerns about the care workers attitudes or behaviour. People told us they felt very safe with their care workers and told us as well as physical safety, care workers ensured their home was secure on leaving them.

People who were supported with medicine (or their relatives) told us they were confident their medicine was administered and recorded properly and people who needed to have topical applications told us these were applied properly and that carers took appropriate hygiene precautions.

We have made a recommendation about the management of some medicines.

The registered provider had a policy and procedure in place for the safe recruitment of staff. However, we found gaps in the information required prior to people being offered a position at the service. This was because full previous employment history was not provided by all staff before they were offered a position at the service.

People benefited because they were supported by staff that had been trained to understand how to provide effective care that met their needs.

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 enjoyed the food provided and were supported by the care workers to receive adequate food and drink to remain healthy.

People told us care workers understood confidentiality, dignity and respect. We were told care workers were very committed to the people they cared for, building a good rapport and taking time to get to know them.

People had been involved in their care plan and involved in agreeing the support they needed. Care plans described the support the person needed to manage their day to day care and health needs. The registered manager was in the process of introducing new more person centred care plans. These would include more detailed information on the person's history, interests and preferences.

People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously.

Improvements were required around the governance of the service as the systems to monitor the quality and safety of services provided did not cover all aspects of service provision and therefore were not fully effective. Call monitoring systems were not fully used and there was no systematic approach to supervisions or appraisals and no oversight of these.

The registered manager sought people who used the service, relatives and staff's feedback and welcomed their suggestions for improvement.

Further information is in the detailed findings below.