Classic Care (Homecare Services) Ltd

Classic Care (Homecare Services) Ltd is a domiciliary care service. It provides personal care to people living in their own homes.

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

We found the service to be in breach of two regulations. These were in relation to the need for consent and good governance.

We made recommendations about the way the service manages medicines.

Medicines were not managed safely. Records were not always completed accurately, and medicine errors were not always identified or acted on in a timely manner.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service provided training for staff however staff told us they did not always have enough training to do their role effectively.

Quality assurance systems were not always effective; they failed to identify concerns regarding safe medicine management, mental capacity assessments and effective monitoring of accidents and incidents.

People were cared for by staff who were recruited safely and in line with national guidance. The service had appropriate safeguarding policies in place and staff were knowledgeable about safeguarding principles.

People who used the service told us staff treated them with kindness and listened to them. Care plans were written in partnership with people and people told us they felt their wishes were listened to in regards to their care.

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 16 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, consent and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

information we may inspect sooner.

The registered manager was in post since the service registered in 2013. 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.

People we spoke with told us staff were caring and considerate and promoted their independence when possible. Staff had established good working relationships with the people they supported and had a good understanding of their care needs. One person we spoke with told us, “I feel safe and confident with the care staff that I have. I have a condition which means I have to be transferred in a specific way to avoid problems. The care staff are experienced and know what to do.”

People told us the care was centred on their wishes. One person told us, “I needed the timings of my visits to be changed. A meeting was held to discuss this with the registered manager, following the meeting the service was able to accommodate my request. This demonstrated choice and control for people who use the service.

Staff knew how to respond to protect people from abuse and how to respond if they had any concerns. One member of staff told us how they raised concerns following a visit. The situation was dealt with by the relevant authorities and the person was protected. We found this to be in line with the service’s safeguarding policy and procedure.

Medicines were managed safely and people had support from staff where needed. For example, some people only required prompting to take their medicines whereas other people required staff to administer their medicines. Staff told us when the medicine was administered the medicine chart was signed to confirm people had received their medicines. Staff received training in the safe administration of medicines.

Safe recruitment procedures were carried out recruitment files we saw contained relevant documentation required to ensure only suitable staff were appointed. Staff received appropriate induction, training and supervisions.

People said they knew how to make a complaint and were given the information to do so when they first joined the service. Staff were aware of the process to follow if someone made a complaint. This was in line with the service’s complaints procedure.

People had access to healthcare services to maintain good health. We spoke with one person, they told us. They have nursing needs as well and they see the community nurse on a regular basis.

The service had effective quality monitoring systems in place to drive improvements and ensure the safety of people who use the service.

Care plans we viewed were drawn up from their initial assessments and were individualised and tailored to people's individual needs and preferences. The care plans contained details about people's medical and social histories which enabled staff to engage with people on subjects meaningful to them.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Potential risks to people's safety had been identified and discussed with people who used the service. We saw examples of good working partnerships with other healthcare professionals to ensure people remained healthy and well. These included contacting people's GP's and district nurses where there was a change in people's condition.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff we spoke with confirmed they had access to a structured training and development programme. Staff told us they enjoyed their work and felt well supported in their roles.

You can see our judgements on the front page of this report.

We looked at care plans. They had a detailed assessment of the person's care needs and how they were to be met. Copies of the referral for care were in place, together with a series of risk assessments.

When we looked at training records and spoke to staff we found not all staff had completed appropriate safeguarding training. This meant staff may not have had the necessary understanding of Buckinghamshire County Council's policy for the safeguarding of vulnerable adults or what procedure to follow when a safeguarding issue arose.

People told us they were aware of there being a complaints policy. There had been no formal complaints from people who received care. People told us they were most likely to raise any concerns if they had them direct with the office. Several people told us they had regular contact with the manager, and were able to raise any issues or concerns with them when they provided care themselves or carried out spot checks on other staff.