Everlasting Care Ltd

Everlasting Care is a is a domiciliary care agency providing personal care to people in their own homes, as well as providing personal care at the provider’s day centre. The service supports older people, including people living with dementia, younger adults, and children. At the time of our inspection there were 50 people receiving the regulated activity of personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of the service and what we found

People felt safe due to the consistency and reliability of the provider, and individual staff members. People received a continuity of care from core staff members they knew well and had built strong relationships with.

Communication from the provider was regular and inclusive, ensuring that people and their relatives were fully informed and involved in the planning of care. The provider had successfully rolled out an electronic care records system, which was working effectively and enabled them to keep real time oversight of core areas, such as call times and medicines administration.

Care calls were well planned and monitored, meaning people and staff were safe. Systems were in place to monitor staff competence and training, ensuring people received care and support from staff who were competent and confident.

The culture was open and supportive. Staff felt engaged in how the service was run and valued for the work they did. The provider worked well with a range of external health and social care professionals.

People, their relatives and external professionals all agreed the service was well managed. They had confidence in the provider and in staff they had got to know over a period of time.

The provider was open to feedback and engaged in provider forums and other external events to stay abreast of good practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 19 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using Everlasting Care receives regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service had a registered manager in post. The registered manager had been in post since the service first registered in 2014. A registered manager is a person who has registered with the 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.

At the last inspection in April 2017 we rated the service as 'Requires Improvement', we asked the provider to take action and make improvements to the induction and training of staff at the service. We also recommended that guidance was sought around specific risk assessments and a review of quality monitoring and record keeping was completed. We found these actions had been promptly completed and good practice has been sustained. We have therefore rated the service as 'Good'.

People were supported by staff to maintain their health, safety and welfare in their own home. The office staff had fully completed risk assessments of the known risks people faced. These were reviewed and updated to reflect changes in people’s needs. Care records now included information in case of an emergency within people’s homes.

New staff had received a company induction and a robust induction programme was now fully embedded into the service. Staff training was up to date. Most staff told us they now received regular supervision sessions, an annual appraisal and staff meetings took place. Records confirmed this. Staff told us they felt supported by the office staff.

The registered manager ensured the service was properly monitored. We saw audits had been improved and new audits and analysis of all aspects of the service had been implemented. We saw action plans were in place to ensure any issues highlighted were dealt with promptly.

Policies and procedures were in place to help staff safeguard people from harm. Incidents of a safeguarding nature had been recorded, investigated, reported and monitored. The local authority had no concerns about the service. People told us they felt safe with the regular support from staff.

Medicines were managed safely. Medicine administration records were up to date and fully completed. Competency checks on care workers were now in place to ensure staff remained competent in their role. Regular unannounced spot checks were conducted to ensure high standards were maintained.

Staff recruitment continued to be safe and robust. There were enough staff employed to safely meet people’s needs. People told us that care workers did not rush their duties and that they had regular care workers who arrived as expected most of the time.

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

Care plans had been re-written and now included person-centred information. We saw a new review system had been implemented following our last inspection to ensure people received suitable care to meet their needs.

People told us that care workers made meals of their choice. External healthcare professionals were involved with people’s care to monitor their health and welfare.

Without exception, people and relatives told us their care workers were friendly and they were respected in their home. People said their dignity and privacy was always maintained.

There was a complaints policy in place. We saw all complaints and minor issues had been logged, investigated and resolved in a timely manner. No-one we spoke with raised any complaints about the service.

Customer and staff surveys had been carried out which showed mostly positive results. Our pre-inspection questionnaire responses corroborated this.

We last inspected the service in December 2014 and rated the service as ‘Good.’ At this inspection we found the service required improvement. This was because they were not meeting some legal requirements.

A registered manager was in post and this manager had not changed since our last inspection of the service. The registered manager was also the provider. 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 registered manager was on annual leave at the time of our visit to the office. On her return, we spoke with her about the service and our findings. She shared further documentation for us to review which had not been accessible to the office staff at the time of inspection.

A robust induction programme such as the ‘care certificate’ had not been fully implemented at the service and because of this some staff had not had their competency assessed against the minimum standards which are expected. Formal ‘on-the-job’ competency checks of experienced staff were not always conducted. Training had not always been routinely refreshed and specific training to meet the needs of the people who used the service such as dementia awareness and challenging behaviour was not routinely arranged.

Risk assessments had not always been carried out to address the individual risks people faced in their daily lives. Those which were in place did not consistently contain plans for managing or reducing risks and required some further development. We have made a recommendation about this.

Some checks were carried out to monitor the quality and safety of the service. Although there was no evidence of auditing or analysis of the overall service, the oversight of service delivery through spot checking of care staff and the records kept in people’s own homes had been effective to a degree and highlighted some areas for improvement which were promptly addressed by the office staff. The issues we found regarding the lack of individual support plans, risk assessments and training had been partially identified prior to our inspection but were not fully addressed. We have made a recommendation about this.

Recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people and there were sufficient numbers of staff employed by the service to meet people’s needs and preferences. We saw evidence of a shadowing period for new staff. All staff were supported though an annual appraisal however formal periodic supervision sessions were not carried out.

There were safeguarding procedures in place. Staff were knowledgeable about what action they should take if suspected anyone was at risk from harm or abuse. The local authority safeguarding team informed us that were no on-going organisational safeguarding matters regarding the service.

Medicines continued to be managed safely and administration procedures were followed correctly by care workers. People's nutrition and hydration needs were met and they were supported to access healthcare services when required to monitor health and well-being.

People’s rights under the Mental Capacity Act 2005 (MCA) were protected. Care staff supported people to have maximum choice and control of their lives in the least restrictive way possible; company policies and procedures supported this practice. Care records showed people were involved in their care and support.

We observed lots of positive interactions between staff and people who used the service. Staff demonstrated a caring and compassionate attitude and they protected and promoted people's privacy and dignity.

All staff were very positive about working for the company, which they described as ‘family run’. They all told us they felt valued and enjoyed their roles. We observed that they projected this positivity when they engaged with people.

Person-centred care plans devised by the service were not always in place. Those which were detailed the individual care and support people required. Information from other agencies such as the local authority was available to staff. Reviews of people’s needs required further development. We have made a recommendation about this.

Care staff demonstrated that they knew people’s likes, dislikes, preferences and routines. Arrangements for social and emotional support met people’s individual needs.

There was a complaints procedure in place. We reviewed the complaints received by the service since our last inspection and saw they continued to be responded to thoroughly and in a timely manner.

We have identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 entitled Staffing. You can see what action we told the provider to take at the back of the full version of the report.