We undertook an announced inspection of ARCH Care Services Limited on 28 November 2016. ARCH Care Services Limited provides personal care services to people in their own homes in and around Clevedon, Nailsea and Portishead. At the time of our inspection approximately 50 people were receiving a personal care service. This service was last inspected on 6 November 2013 and found to be compliant in all the areas we looked at. During this inspection we found no breaches of regulations and we found people received a good service.People were kept safe and free from harm. People using the service, and staff, had access to a 24 hour ‘on-call’ service, which meant they could ask for guidance or additional support at any time.
The provider had a robust recruitment process which minimised the risks of abuse to people. Staff had received training and information on how to recognise and report any suspicions of abuse and they were confident any concerns would be acted on promptly.
There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the person who used the service or their relatives. One person said, “I sometimes need help outside of my usual hours and they have always tried to get to me as soon as they can.” People were confident staff were never rushed and always stayed for the correct length of time.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. There were systems in place to ensure people received their medicines safely from staff who were trained and competent to carry out the task. Continuous observation and auditing ensured these systems were maintained and action taken to minimise the risk of errors, for example additional training for staff.
Staff knew the people they were supporting and provided a very personalised service. Care plans were in place detailing how people wished to be supported and people and/or their relatives were involved in making decisions about their care. People told us they liked the staff and found the care to be good. Peoples’ comments included, “ They [the staff] understand me and know about my needs. They make my life easier and take the pressure off me” and ““They cater to my every whim!”
People were supported to eat and drink if required. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. For example, they contacted social services and occupational therapists if people’s care needs increased and they required more time or equipment. Care plans were reviewed regularly which meant staff were able to continue to meet people’s needs as they changed. Effective communication systems ensured that this information was shared promptly with the person and the team supporting them, with the person’s consent.
Staff had received training and had an understanding of the requirements of the Mental Capacity Act (2005) (MCA), which meant people’s legal rights were protected. People who used the service and others involved in their care were fully involved and consulted. People were always asked for their consent before staff assisted them with any tasks. Staff respected people’s privacy and people were treated with respect and dignity. The service had developed a ‘Dignity Champion’ role and produced a Dignity in Care newsletter. People’s comments reflected a focus on personal care provided in a way that maintained their dignity. Comments had included how people receiving the service helped to make them feel ‘human’ and cared for.
Due to the commissioning process the service had recently lost the tender to provide care to some people. This meant that unless people were privately funded or used a direct payment scheme they would soon have their care needs met by a different agency. Everyone we spoke to said they would prefer to remain with ARCH where possible and were very happy with the personalised service provided.
There was a registered manager who managed the service well. A registered manager is a person who has registered with 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 and associated Regulations about how the service is run. The registered manager was clearly well liked by people using the service and staff. They were accessible and approachable. Staff, people who used the service and relatives felt able to speak with the registered manager and there were opportunities to provide regular feedback on the service. The registered manager/provider had a ‘hands on’ approach and had developed positive relationships with people who used the service and their families and continued to look for improvements. For example, the service had an allotment where staff invited people to come and help with gardening as a social event free of charge. Staff told us they were well supported by them.
There were effective systems in place to monitor the quality of the service, including regular spot checks, audits and regular satisfaction surveys for people who used the service and staff. The focus was on being open and transparent and continuing improvement for the benefit of people who used the service.