Alexandras Community Care St Austell

The inspection took place between the 25 and 30 May 2016 and was announced. This was because we needed to ensure staff would be available in the service office during the inspection visit. Not everyone using Westcountry Home Care receives regulated activity; 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 take into account any wider social care provided.

The service does have a registered manager in post who was on authorised absence at the time of our inspection. 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.

At the time of our inspection the service was being led by an acting manager with support from the provider's nominated individual and registered managers from other Westcountry Home Care Limited services who visited each week. The acting manager told us they felt well supported and commented, "The other managers have been great."

Staff told us they had been well supported during the registered managers absence and commented, "It's been fine while the registered manager has been away. I don't want to give the deputy manager a big head but she is doing well." While relatives said, "The manager is very open and gives you straight answers." There were appropriate on call arrangements in place that enabled people and staff to access management support outside of office hours.

People felt safe and got on well with their support staff. Their comments included, "I feel safe and I am very happy the individual carers", "No complaints in the girls work at all, whatever I ask they do" and "I get on very well with [the staff]. We have a laugh and a joke." Staff said, "I love the job" and told us they enjoyed spending time with the people they supported. Staff understood their role in protecting people from all forms of abuse and had a good understanding of local safeguarding procedures.

The service recruitments practices were safe and there were enough staff available to provide all planned care visits. Our analysis of visit schedules and daily care records found no evidence of care visits having been missed. People told us, "They've never missed a visit" while staff commented, "I am not aware of any missed visits. It is not something that happens on a regular basis." Visits schedules were developed a week in advance and only changed in response to staff sickness. Each week people were provided with

individualised booking schedules so they knew the planned timing of each care visit and which staff were due to support them.

Care visits were normally provided for the full duration. However, we received mixed feedback from people and staff in relation to their arrival times. People's comments included, "The staff are normally on time, I don't feel rushed", "Generally the staff come within a reasonable time frame. Things have improved slightly as the administrator now rings if staff are running late" and "They were half an hour late today so had to ring the office. It does not happen a lot, maybe once per week".

Most staff told us they received adequate amounts of travel time between consecutive care visits but concerns were raised in relation to the travel time allotted on one particular visit schedule including, "lf the travel time was honest on the rota then everything would be fine, sometimes you are driving for 30 minutes but only have 10 minutes travel time." Our analysis of the travel time allocated on this route found that staff had been allocated on average less than half of the time necessary to travel between visits. We have made a recommendation in relation to this issue.

This issue was raised with the acting manager who was aware of the situation and working to resolve it. Following the inspection the acting manager confirmed the issue had been resolved.

Records showed that staff team were sufficiently skilled to meet people's need and that training had been regularly updated. There were appropriate induction procedure in place for new staff and all staff had received regular supervision. People told us, "I think they have the skills they need" and "They know exactly what they are doing."

Staff had a good understanding of the Mental Capacity Act. People were able to choose how their support was provided and their decisions were respected by staff. People felt able to request additional unplanned support during care visits and staff ensured people's needs were met. Care plans were sufficiently detailed and informative. They provided staff with the appropriate and specific guidance necessary to help ensure people needs could be met.

The service's records were well organised and there were effective quality assurance systems in place. Performance audits had been completed and, where any issues were identified, action plans had been developed to make sure these issues were addressed and resolved. People's feedback was valued and when complaints were received these had been investigated and resolved.

The five questions we ask about services and what we found