Archived: Handle with Care Coventry & Warwickshire

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff who supported them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People who used the service told us they had an assessment completed when the service started to make sure the service could meet their needs. People we spoke with told us they had reviews to make sure care plans were accurate and up to date.

We found there was a process for managing risks associated with people's care. Where people had been assessed as at risk of dehydration and malnutrition support required with food and drinks had been recorded in care plans.

Some people who used the service were unable to move around without assistance. There was detailed information in care plans for care workers about how to move people safely.

All the people we spoke with said they felt safe with their care workers.

Is the service effective?

People told us they had been involved in planning their care and the care they received met their needs. We saw care plans had been reviewed and updated so care workers could continue to provide the correct level of support.

People said they had regular care workers who arrived around the time expected and stayed long enough to do everything they needed.

We found staff had their practice observed to make sure they provided care and support in line with the provider's policies and procedures.

We found the quality monitoring systems were in place to make sure people received the care and support recorded in their care plans.

We found there were sufficient care workers available to provide the care and support people required.

Is the service caring?

Relatives and people who used the service told us care workers carried out personal care in the way they preferred. People we spoke with said care workers routinely checked to make sure people's skin was not getting sore and applied prescribed creams if any redness was noticed.

We asked people if care workers treated them in the way they liked. Everyone indicated that people were treated with dignity and respect. Comments from a relative included, 'They (the care workers) treat him with the utmost respect.'

Is the service responsive?

People told us they were asked for their views and opinions during reviews and any changes were recorded and acted on.

People told us that complaints were listened to and acted on.

Care workers said they reported any changes in people's care to the office and that care plan would be updated if needed.

We saw care plans were individual and contained detailed information about people's care, including their personal preferences. We saw one person had allergies to specific foods; this had been clearly identified on their care plan.

Is the service well led?

The service had a designated management structure in place and senior staff had clearly defined roles and responsibilities. Staff we spoke with said the service was well managed and there was always someone available in the office to give advice and support.

We found the service had quality assurance systems in place. These included reviews with people who used the service and care worker spot checks

There were auditing procedures in place for checking people's completed daily care records and medication administration records. This made sure people received the care as recorded in their care plans and care workers worked in line with the provider's procedures.

People who used the service told us they were satisfied with the service they received. Comments from people included, 'I would recommend the agency to anyone.'

The providers report told us they had made several improvements to how records were being managed.

The report told us client reviews had taken place and care records were now up to date. When documents were brought back to the office for filing they would be screened and signed before they are filed. This would make sure all aspects of the call had been completed and signed for correctly.

The report stated records would be checked and signed for during visits by senior staff. There would also be a monthly audit of all staff and client files.

The agency had introduced new forms for recording medication and food and fluid intake, as well as other monitoring forms.

An auditing procedure was in place to ensure staff supervisions, spot checks and staff training were taking place and had been recorded accurately.

The report from the provider showed that appropriate action had been taken to ensure records were accurate and fit for purpose.

People we spoke with said they were happy with the care they received. One person told us, 'I'm very happy with the agency; there is nothing I would change.' Another person said, 'Yes, I am more than satisfied with my carers. I have two carers for every visit and they are all fantastic.' All the people we spoke with said the care workers were friendly and polite.

We found that people had given their consent to the care and treatment to be provided and had signed a document to confirm this. All the people we spoke with said they had a copy of their care plan. Records we looked at showed the agency regularly reviewed the care provided to people. We found people received their medication at the times prescribed. There were processes in place to safely recruit staff and provide staff with the training and support to meet people's care needs.

We found there were procedures in place to assess the quality of the service but there were no records to evidence how some of these had been put into place.

We found the record keeping in the agency was not always accurate, up to date or available to be viewed. This could result in people receiving inappropriate or unsafe care.

We spoke to staff, observed policies and processes, reviewed eight sets of notes and contacted eight people who use the service or their families to gain further insight into the care provided.

The people we talked to were generally satisfied with the care they had received and commented that having the care enabled them to remain in their own homes and be as independent as possible. One person said 'all the carers treat me well and with respect'. Another said 'I enjoy their company".

We found evidence of quality management processes including complaints and compliments. However, there was evidence that updating care plans, some risk assessments and the processes for auditing and recording medication require review. Also the provider needs to implement processes linked to CAS alerts and review the current arrangements for keeping secure entry information safe.

Systems were in place to ensure staff had the appropriate training and had been assessed as competent. We found evidence of appraisal, supervision, initial and on-going training to ensure competence. Staff felt very satisfied with the training provided, had attended induction and ongoing development. Staff were happy in their roles, enjoyed working for the agency and said that they felt supported.