About the service:

Two Hoots is a domiciliary care agency, set up to provide care to people in their own home. At the time of inspection, there was one person using the service.

People’s experience of using this service:

The person using the service felt safe and had confidence in the provider to act on any concerns. The person told us, “I feel safe now. I have no worries. I have people around me that actually care about me and I get on well with all my staff.” The person and provider were honest about the fact that in the previous year there had been times when the care had not been good. The registered manager had taken action to rectify this, which included employing an entirely new staff team and reviewing how the company worked. We understood from conversations that in many respects this meant the service was starting anew and things were still settling.

The registered manager and staff worked closely with the person to involve them in changes and decisions over how their care was provided. This included involving the person in recruitment and staffing decisions. It was clear that the previous year had been difficult and we considered some areas of improvement with the registered manager, to ensure lessons were learned to prevent reoccurrence of events. The registered manager and operations manager were engaged with our inspection and open to feedback, to ensure improvements would be made. This included aspects of governance, record-keeping and quality assurance that needed to be developed to underpin safe, good care. Our judgements reflect what we found at the time of our inspection and the experience of the care the person had in their own home at the time of our visit, which was good.

Recruitment was ongoing to rebuild the person’s staff team, however they felt there were enough staff to meet their needs. Safeguarding and risk management processes were in place, which staff were aware of and in which the person was involved. The person checked their own medicines and took them with support from staff.

The service focussed on good outcomes for the person and a promotion of their independence. The person and staff spoke warmly about each other and we observed caring, encouraging and respectful interactions. Training for the new staff was being rebuilt, but the registered manager was at hand to show staff what they needed to learn. Comprehensive care plans were in place to provide staff with person-centred knowledge. Care was personalised and responsive to individual needs.

The service continued to meet the characteristics of Good in most areas. More information is in the full report, which is also available on our website at www.cqc.org.uk.

Rating at last inspection: Good (22 September 2016)

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and checking relevant notifications

This inspection was announced and took place on 4 August 2016. Our last inspection took place in November 2013, and at that time, we found the provider was meeting the regulations we looked at. The service was registered to provide personal care support to younger adults and people with a physical disability. At the time of our inspection, one person was using the service.

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.

The person was protected from abuse and avoidable harm. Risks were managed safely and people were involved with these decisions. Plans were in place to deal with emergencies. There were sufficient staff to meet the persons needs and ensure their safety. Medicines were managed safely for the person.

Staff had the knowledge and skills to carry out their roles to meet the person’s needs. They were able to make their own decisions about their care, and staff gained consent before supporting them. The person was supported to have sufficient to eat and drink, and were enabled to maintain their health and well-being.

Positive caring relationships were developed with the person who used the service. Their privacy and dignity was respected and prompted. The person was enabled to be as independent as possible, and they were able to maintain relationships that were important to them.

The person received individualised care that was responsive to their needs. They were involved in the planning of their care and support. The person knew how to raise any concerns or complaints, and the provider responded to these in a timely manner.

There were systems in place to monitor the quality of the service though feedback from the person who used the service and a programme of audits. The provider acted upon these to make improvements within the service.

‘Two Hoots’ was set up to provide personal care for people in their own homes. The provider was a limited company, Unique Care Ltd. One of the company directors was also the registered manager for the service. At the time of our inspection, one person was using the service. This person was related to the registered manager.

We spoke with the person who received 24 hour care from Two Hoots. They told us the service met their needs and provided care according to their own wishes. They said that they determined how the care was organised over the 24 hour period. They told us that they had: “A great group of guys” supporting them.

We looked at the care plan for the person who used the service. We found that it provided a detailed assessment of the person’s needs. The care plan described how the person preferred to be supported. It outlined risks associated with providing care for the person. We saw that the person had given their written consent to receive the service.

We spoke with two care workers and looked at the employment files for nine members of staff. We saw that staff had been recruited appropriately and that checks had been made with the Disclosure and Barring Service (DBS).

We found that the administration of the person’s medicines was managed in a safe and appropriate way. There were sufficient systems in place to ensure the person who used the service was consistently supported in a way which promoted their wellbeing.