About the service:

Explora Haven is a domiciliary care agency which provides personal care in people’s homes and buddy services to people with learning disabilities, younger adults and older people. Buddy services included accompanying people to activities and outings. The services they provide include personal care, housework and assistance with medication. On the day of our visit the service provided care and support to approximately 95 people.

People’s experience of using this service:

The provider did not always follow safer recruitment practices. Appropriate recruitment checks were not always carried out to ensure we could be confident that staff provided were safe to support people who used the service unsupervised in their home. The service quality assurance monitoring systems were not effective and did not pick up on the shortfalls found in respect of safer recruitment practices.

People who used the service felt safe with the support they received from the staff. People who used the service told us, “I’ve had the same person for [several] years and she never let me down. I feel totally safe with her.”

Staff had a good understanding of how to raise any concerns if they felt people who used the service were not safe or had been abused.

People and staff told us they felt they were listened to and that the provider would address any concerns they might have.

Where people received support with their medicines this was managed safely.

Usually the same team of care workers supported people who used the service. This maintained consistency and ensured that staff knew people and could built friendly professional relationships with people.

Where people received support with their nutrition and hydration this had been documented clearly in the care plan.

Staff received a wide range of training, which they said was useful. Staff felt supported by their manager, but occasionally supervisions were not provided within the time stated in the providers supervision policy. However, this had no impact on the care and support provided to people and care workers.

Where possible people were involved in making their own decisions about their care and staff sought appropriate consent and asked people.

People received care that respected their privacy and dignity as well as promoted their independence wherever possible.

Most people were supported by their relative to access external healthcare support, However, when people required support in this area, this was documented in their care plan and medical appointment were arranged if they felt unwell.

Care records and assessments were detailed and reflected people’s needs and wishes.

A dedicated management team led the service. The management team and office staff demonstrated compassion and commitment to the needs of the people who used the service as well as the staff who worked for them.

The service worked with external agencies. The registered manager and nominated individual promoted transparent communication, honesty and were approachable.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 about staffing and safer recruitment practice. We have made a recommendation about seeking guidance to maintain effective governance. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: Good (Published August 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. During our last inspection we rated the service ‘Good’. At this inspection we found the service did not maintain the rating of ‘Good’ and we rated the service ‘Requires Improvement’.

Follow up: We will continue to monitor intelligence we received about the service until we return to visit as per our re-inspection programme. If any concerning information was received, we may inspect sooner.

We undertook an announced inspection of Explora Haven Training and Support Services Limited (Explora Haven) on 30 June 2016. Explora Haven is a domiciliary care agency which provides personal care in people’s homes and buddy services to people with learning disabilities, younger adults, children and older people. Buddy services included accompanying people to activities and outings. The services they provide include personal care, housework and assistance with medication. During the day of our visit the service provided care and support to approximately 75 people, approximately five people received buddy services which did not include personal care.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The provider changed their legal entity from Broadways Limited to Explora Haven Training and Support Services Limited in June 2015. We undertook a rating inspection in January 2015 of Broadways Limited and the provider had an overall rating of good. This is the first inspection since changing the legal entity to Explora Haven Training and Support Services Limited.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and care workers were aware of potential risks to people and how to protect people from harm. These included details of the triggers and warning signs which indicated when people were upset and how to support people appropriately.

People told us their care workers turned up on time and they received the same care worker on a regular basis and had consistency in the level of care they received.

We checked the arrangements in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place.

People were cared for by care workers that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service and said that they received support from management and morale amongst staff was positive.

Care workers had a good understanding of and were aware of the importance of treating people with respect and dignity. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from relatives indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

People received care that was responsive to their needs. People’s daily routines were reflected in their care plans and the service encouraged and prompted people’s independence. Care plans included information about people’s preferences.

The service had a complaints procedure and there was a record of complaints received. Relatives spoke positively about the service and told us they thought it was well managed. There was a clear management structure in place with a team of care workers, office staff and the registered manager.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through quarterly review meetings and telephone monitoring. Records showed positive feedback had been provided about the service.