Croft Care Services

The inspection of Croft Care Services took place on 17 July 2018 at their offices and was followed by telephone calls to people using the service and care staff between 19 and 24 July 2018.The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

At our previous inspection in April 2017 we rated the service as 'Requires Improvement'. We identified two regulatory breaches which related to safe care and treatment and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions – safe, effective, responsive and well led, to at least good. This inspection was to check improvements had been made and to review the ratings.

There was a registered manager in post and available at the time of the 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.

We found improvements had been made in regard to risk management and medicines. Risk management plans were person-centred and contained information in relation to equipment and method, including pictorial guidance for staff to follow. Risk reduction measures were reflective of individual need. Medicines management was safe as staff were able to explain the process in detail and audits ensured effective oversight was in place.

People told us they felt safe with care staff, and we were confident staff knew how to recognise safeguarding concerns and what action to take in the event of having such a concern.

However, we did find some issues with call times from both the recipient and staff perspective. This was not across the whole service but some people felt staff were often late and problems only usually arose in the absence of their regular care assistant. This showed much of the care delivery was consistent but covering absence needed further consideration. Staff had a mixed experience where some felt their workload was appropriate but others felt rushed, with little time to travel between calls. Most staff told us they stayed the full duration of the call and analysis of call times confirmed this. We recommend the registered manager reviews the rotas to ensure staff have sufficient time to complete the required tasks and travel between calls.

The registered manager displayed a sound knowledge of current practice based on a number of sources and

was keen to maintain this. This was enhanced by the provider who also took a pro-active approach to ensuring knowledge and policies were current.

Staff received an induction, supervision and training and people felt staff were confident in their duties. Staff felt their colleagues were supportive of each other.

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.

People had appropriate nutritional support and were supported to access other services as required if their needs changed. We saw some pro-active involvement by the service when one person's mobility changed.

We found people spoke positively of the care staff, describing them as kind and friendly. There was evidence of some strong relationships between people and care assistants, and compliments we read reinforced this view.

People felt and were engaged in the process of designing and agreeing their support plans, and these were regularly reviewed to ensure they reflected current need. People told us their preferences were obtained and these were respected, such as with the gender of care staff.

Everyone told us their privacy and dignity were promoted.

Care records were accurate and reflected people's needs, providing staff with an overview of the person's needs. Daily records showed sufficient detail to evidence appropriate care delivery.

Complaints were handled with an apology, and full investigation of which the outcome was shared with the complainant. People knew who to approach if they had any issues and were confident they would be resolved.

The service had a registered manager who had developed the service and addressed the issues we found at the last inspection. The quality assurance systems meant records and people's experiences were regularly evaluated and practice checked. The issue with call times was agreed for further consideration by the registered manager and provider to ensure service delivery was as robust as possible.

The five questions we ask about services and what we found