We undertook an announced inspection of Home Care Preferred Limited on 14 August 2018. Home Care Preferred Limited provides a range of domiciliary care services which include live-in care and support, administration of medication, food preparation and housework.CQC only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of inspection the service provided care to 98 people, of which 54 people received ‘personal care’.
There was a registered manager in post. 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.
Our previous inspection of the service on 30 July 2015 rated the service as Good with no breaches of Regulation. During this inspection on 14 August 2018, we found that the service remained Good.
The majority of people who received care from the service were unable to communicate with us verbally. We therefore spoke with people’s relatives. People who used the service and relatives told us they were satisfied with the care and services provided and spoke positively about the service. People told us they were treated with respect and felt safe when cared for by support assistants and this was confirmed by relatives we spoke with. They spoke positively about them and the management at the service. The provider refers to care workers as "support assistants" and therefore for the purposes of the report we have referred to them as "support assistants".
Procedures were in place to protect people and keep them safe. Staff knew how to identify abuse and understood their responsibilities in relation to safeguarding people and reporting concerns. There were safeguarding and whistleblowing policies in place.
Risks to people's and staff safety were identified and guidance was in place to manage and minimise risks of people being harmed and protect them. We found risk assessments were comprehensive and included personalised guidance for support assistants to follow to keep people safe minimise the risk of people being harmed.
The service carried out appropriate checks so only staff who were suitable to work with people using the service were employed by the service.
Appropriate arrangements were in place in respect of medicines management. Medicines administration was recorded electronically and we noted that all records were up to date.
People had been visited by the service who carried out an assessment of their needs prior to them receiving care. People received personalised care and the service was responsive to their needs. People were consulted about how they would like to receive their care and their preferences were supported. People's care plans were up to date and included information staff needed about how best to support them. People’s daily routines were reflected in their care plans and the service encouraged and prompted people’s independence. Care support plans included information about people’s life history.
The service had an electronic system in place to monitor care worker's punctuality. People told us their care workers turned up on time and they received the same support assistant on a regular basis and had consistency in the level of care they received. Management at the service explained that consistency of care was an important aspect of the care they provided.
People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences working for the service and said that they received support from the registered manager.
People's dietary needs were understood and supported by the service. People received the assistance and support that they needed to ensure their nutritional needs were met.
Staff had a good understanding and were aware of the importance of treating people with respect and dignity. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from people indicated that positive relationships had developed between people using the service and their support assistants and people were treated with dignity and respect.
The service had a comprehensive service user guide which was provided to people who used the service and they confirmed this. It also included information about their philosophy of care, principles and values which included, “Quality, Passion, Integrity, Choice, Dignity, Independence and Equality.”
The managing director explained that an important aspect of the service was to get involved with the community. The service was responsible for organising various community events such as social club events and music events which included a comedy night fund raiser, dementia awareness talks and a charity Gala.
The service had a complaints procedure and there was a record of complaints received. Complaints we examined had all been responded to appropriately.
People and relatives spoke positively about the management of the service. There was a clear management structure in place which was made up of the managing director, registered manager, senior management, care coordinator, team leaders, administrative staff and support assistants.
Systems were in place to monitor and improve the quality of the service. We found the service had a comprehensive system in place to obtain feedback from people about the quality of the service they received through review meetings, telephone monitoring and home visits. The service implemented their own ‘quality assurance schedule’. This provided a structured system for obtaining feedback from people and relatives and ensured that this was consistently carried out for all people. It included a courtesy telephone call within 48 hours of a person’s first visit, a client survey within two weeks, a review within six months and client survey at 12 months.
The service undertook a range of audits of the quality of the service and took action to improve the service as a result. Audits had been carried out in relation to care documentation, staff files, medicines and training.