This announced inspection took place on 5, 7 and 12 September 2017. We last inspected Ginger Homecare in January 2016. At the inspection in January 2016 we rated the service as ‘Good’ overall and for all the individual domains of ‘Safe’, ‘Effective’, ‘Caring’, ‘Responsive’ and ‘Well-led’.Ginger Homecare Limited is a privately owned domiciliary care agency providing practical and personal care to people living in the local community. The agency operates from an office base in Farrington, Lancashire.
At the time of our inspection there were approximately 120 people receiving a service from the agency which equated to approximately 1000 hours per week. The vast majority of people using the service had their hours commissioned by the Local Authority.
The Registered Manager was present during the inspection of the registered premises and was cooperative throughout the inspection process. 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 Deputy Manager was also present throughout the inspection and was also cooperative. Both had worked at the agency for over 20 years.
People who received a service from Ginger Homecare told us they felt safe when staff from the agency visited them in their own home.
People we spoke with told us they were supported well to take their medicines on time by a competent staff team. We did however see some examples within care plans were people’s current needs were not reflected in this area and we have made a recommendation about this.
People’s needs were risk assessed prior to receiving a service from the agency. As with medicines management risk assessments, we found some examples where people’s current needs, were not consistent with the information within their care plan. We have made a recommendation about this.
People told us the staff that came to provide care and support were well presented and wore personal protective equipment (PPE) when assisting them with personal care. Staff confirmed with us that they had enough PPE to carry out their duties effectively.
We spoke with staff and asked them if they were supported to carry out their role effectively. All the staff we spoke with told us they felt supported by management and peers.
We saw evidence that staff received a thorough induction when they first started work with the agency and that they received a variety of training once they were established. Staff also received three monthly supervisions and an annual appraisal.
We found some conflicting information with regards to how people gave their consent. The agency had introduced a new system and paperwork to resolve this issue prior to the inspection process finishing.
People we spoke with told us they were happy with the care and support they received and that staff were caring and considerate in their approach. People and relatives we spoke with raised no issues with respect to dignity, privacy or confidentiality.
Improvements had been made to care plans in terms of the detail within them and how they related to individuals. This had been an issue raised at the previous inspection. Whilst some work was still needed, to ensure care plans were fully reflective of people and their current needs, we could see that a lot of work had gone into this aspect of the service. People told us they were involved in the review of their care if they wished to be.
The agency had an up to date complaints policy in place and we saw that complaints were responded to and investigated in line with their published procedures. People we spoke with told us they knew how to raise complaints.
People, relatives and staff we spoke with talked positively about the management of the service and told us they considered it to have a positive culture. People we spoke with were able to tell us who the registered manager of the service was and that she was approachable.
Staff we spoke with were knowledgeable about adult safeguarding procedures and how to recognise and report potential issues in this area. However, there were several examples of potential safeguarding issues that should have been notified to the Care Quality Commission which had not been. We have made a recommendation about this.
The agency had several quality monitoring and auditing tools in place including external checks on their processes and systems via an external agency. We saw evidence to show that issues raised were dealt with and also were a catalyst to make changes to the service to make improvements.