Background to this inspection
Updated
3 February 2021
The inspection
As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission conducted an inspection of this provider on 17 November 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as electronic file sharing, video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.
Inspection team
The inspection team comprised of an inspector, an assistant inspector, a member of the CQC medicines inspection team, and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We contacted the registered manager three weeks before site visit activity began so they had time to share documents we needed to view and could arrange telephone calls for us with people using the service and relatives.
Inspection activity started on 17 November and ended on 26 November 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We looked at all the information we held about the service and sought feedback from the local authorities and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service and 21 relatives. We reviewed care records and associated medicine records for five people. We looked at a range of records relating to the management of the service including safeguarding and complaints records, meetings, staff recruitment and training, reviews and audits. We spoke with seven members of staff including the registered manager, area manager, four care workers and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We checked a sample of policies. We reviewed written feedback from people who used the service, relatives and healthcare and social care professionals.
After the inspection
We continued to seek clarification from the nominated individual and the registered manager to validate evidence found.
Updated
3 February 2021
This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.
About the service
Continued Care from Oakville Ltd – Harrogate is a domiciliary care service providing personal care to people living in their own homes. It provides a service to older adults, people living with dementia, younger disabled adults, adults with a learning disability or autism and children. When we inspected there were 144 people using the service.
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 using this service and what we found
People spoke extremely positively about staff care, kindness and understanding. Managers fostered a culture continually improving, high quality and compassionate care. The provider had continued to introduce innovative practices and new ways of working including throughout the Covid-19 pandemic. For example, the introduction of the electronic system had fostered excellent trust for families and enhanced collaboration and communication. One person told us, “From my experience they are exceptional, they keep good records of everything, communication with me is first class and they have given me peace of mind.”
Effective infection prevention and control systems were in place to protect people. People told us they felt safe and well cared for. They said staff were well trained and had an excellent understanding of their needs and preferences.
Enough staff were employed to meet people's needs in a timely way. Medicines management procedures were in place. People did not report any concerns regarding their medicines.
The provider acted proactively to make sure staff continued to receive training throughout the Covid-19 pandemic. This included training videos on how to use personal protective equipment safely.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture.
Right support
People received personalised support. Staff knew people and understood what was important to them and the best way to provide care to them. People told us staff had developed creative ways to communicate and to increase their self-confidence and maximise independence. “[Name] needs to be stimulated and alert and have fun and they [Staff] do all these things for them.”
Right care:
There was a positive staff culture that was person-centred and inclusive. People received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
Right culture:
The quality of the service provided reflected the need for people with learning disabilities and autism to live meaningful lives that include control, choice, and independence. The service had a strong emphasis on continuous improvement and research was carried out into current best practice.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 15 January 2019).
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Continued Care from Oakville Ltd – Harrogate on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.