About the service:

Rose of Sharon Care Services is a Domiciliary Care Agency that is registered to provide personal care to people living in their own homes. People who used the service had a range of support needs related to old age, dementia and physical disabilities. At the time of our inspection the service supported 10 people with personal care.

People’s experience of using this service:

People confirmed what the provider told us at the time of our inspection, that there had been difficulties maintaining the service to a good standard in late 2018 due to staffing difficulties. The provider had recognised action was needed and had reduced the size of the service provided so that people received a more timely and better standard of care. The provider does need to embed these improvements to ensure that there is no repeat of the difficulties encountered previously, and the standard of care is maintained.

People and their relatives told us they felt safe with care staff and staff could tell us how they should keep people safe and minimise identified risks to their safety. People and care staff told us due to recent changes the timeliness of staff in attending people’s care calls and stopping for the duration of the call had improved since the previous year.

People were supported by care staff that were caring, showed compassion and expressed interest in providing good care for the people they visited. People told us they received good care and support that was based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop a good relationship with the people they visited.

People were supported by care staff who had a range of skills and knowledge to meet their needs. Staff understood, felt confident and well supported in their role, although there was scope to expand their knowledge in respect of some people’s health conditions. People's health was supported as staff worked with other health care providers to ensure people’s healthcare needs were met.

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

People's care plans reflected their needs and preferences and the staff could explain recent changes to people’s care. Where there was changes in people's needs we saw these were reflected in their care plans and staff were aware of these.

People knew how to complain and that any concerns would be listened and responded to by the provider. The registered manager saw complaints as useful feedback from which to develop and improve the service and they had took the appropriate action to make these improvements when needed.

People, relatives and staff gave us a positive picture as to the quality of care people received, and said they could share their views with the provider.

Quality monitoring systems included audits, spot checks on staff practice and regular checks on people’s satisfaction with the service they received, by surveys, phone calls or visits from the provider. The provider has systems in place to ensure they kept up to date with developments in the sector and changes in the law.

People and relatives told us the registered manager and staff were approachable, organised, listened and responded to them and acted on feedback when they shared this with them.

Rating at last inspection: The rating for the service at our last inspection was ‘requires improvement’ (Published on 09 June 2017).

Why we inspected: This was a planned comprehensive inspection that was due based on our scheduling targets.

Enforcement:

No enforcement action was required.

Follow up:

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

This announced inspection took place at the provider’s office on 27 April 2017 with phone calls undertaken to people with experience of the service on the 2 May 2017.

Rose of Sharon Care Services are registered to deliver personal care. They provide domiciliary care to people living in their own homes. People who used the service had a range of support needs related to old age, dementia and physical disabilities. At the time of our inspection 26 people received personal care from the provider.

The service had a registered manager. 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 arrangements for the administration of medicines we saw were adequate, however we found that Medicine Administration Records [MAR] generated by the provider were in need of more frequent update and needed more detailed information. People were protected from abuse because staff understood what action to take if they were concerned someone was being abused or mistreated. People's risks associated with their care were effectively managed. The systems in place ensured that staff recruited had the right skills, experience and qualities to support the people who used the service. People were supported by sufficient numbers of care staff who arrived on time and stayed for the correct amount of time allocated.

Care staff received an induction into their role before commencing work more independently. The provider ensured care staff had the correct skills to carry out their roles effectively. The management team carried out spot checks on care staff to ensure they were competent. Care staff used supervision as an opportunity to discuss areas where they needed support and review their performance. Consent was sought by care staff before they provided people with assistance in line with the principles of Mental Capacity Act. Referrals to relevant healthcare services would be made as required when changes to people’s health or wellbeing were noted.

People were positive about the care staff that supported them. Care staff spoke with warmth and compassion about the people they supported. People and their family were involved in their care planning. Wherever possible people received their care from a small core group of care staff. People were treated respectfully by care staff who took practical steps to help them remain independent.

People's views and wishes were taken into account when planning care. Care staff fully involved people in deciding how they received their care. Care staff were knowledgeable about how people liked to be supported and what was important to them. Care records were reviewed regularly and updated as required. People knew who to contact if they needed to raise a concern or make a complaint.

The provider had failed to advise us of an incident that was reportable to CQC and other external agencies. Audits in place that were used to assess the quality and safety of the service were not always comprehensive in terms of what they were checking for. A clear management structure was in place and accessibility to support for care staff was available in and out of office hours. People's views and feedback was regularly sought to ensure they received quality care and that the service was run in the way that the provider would like it to be. Spot checks were undertaken by the management team on the support provided by care staff to people in their homes to ensure the care delivered was safe and of good quality.