About the service:

¿ Absolute Healthcare Providers are a community health care service who also provide people with domiciliary care.

¿ They predominantly provide care to people living in North Hampshire.

¿ They were providing personal care to 31 children and adults at the time of the inspection, several of whom were living with complex healthcare needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

¿ People felt valued by the staff who provided their care. They looked forward to their visits.

¿ Staff understood and recognised people’s individuality. They adapted their practices to reflect people’s personal wishes and preferences about how they wanted their care provided.

¿ People felt involved by staff in decisions about their care.

¿ People told us staff understood their individual routines, which was important to them.

¿ People reported they received consistent care from staff they knew and trusted. They received their care at the times they wanted and knew who was due to visit them.

¿ People told us the service was efficient and well-led.

¿ Staff were well trained, skilled and well supported in their role.

¿ People’s needs were comprehensively assessed prior to the commencement of their service.

¿ Staff had a good understanding of the risks to each person and how to keep them safe.

¿ People received their medicines safely from trained, competent staff.

¿ Staff worked across agencies and providers and with health care professionals to ensure people received effective care focused on the achievement of good outcomes for them.

¿ 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.

¿ The provider used technology effectively to ensure people received timely care and support.

Rating at last inspection:

¿ At the last inspection the service was rated good (20 December 2016).

Why we inspected:

¿ This was a planned inspection to check that this service remained good.

Follow up:

¿ We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

This inspection took place on 11 November 2016 and was announced. Absolute Healthcare Providers is a domiciliary care service and at the time of the inspection was providing personal care to 37 people living in their own homes.

At the time of the inspection 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.

People told us they were happy with the service they received from Absolute Healthcare Providers and felt safe using the service. Risks to people and staff were assessed and staff were provided with guidance on taking appropriate measures to mitigate any identified risks. Staff had received training in safeguarding people and had a good awareness of how to keep people safe. They had access to policies and procedures to guide them.

Recruitment procedures were robust and relevant checks were conducted to help ensure only suitable staff were employed. Staff received training and had their competency checked to ensure they had the skills to care for people safely and effectively. They were provided with support through one to one supervision meetings, team meetings and annual appraisals. Staff had the opportunity to gain qualifications and develop their skills further.

People received their medicines safely and when they were required. Medicines administration was monitored and audited closely. Accidents and incidents were recorded, monitored and analysed for trends. Staff knew how to deal with emergencies and contacted appropriate services when necessary. The provider had a business continuity plan in place to deal with emergency situations.

Staff understood their responsibilities in relation to gaining consent before providing support and care. They protected people’s right to make decisions and offered people choice.

People told us they were treated with kindness, dignity and respect and told us they were involved in decisions about their care. They said their decisions were respected and they felt they had been listened to. People’s care and support needs were reviewed regularly with them.

Staff received up to date information regarding changes to people’s wellbeing promptly to ensure they could provide safe and effective care. Staff contacted healthcare professionals to seek advice when necessary. People’s nutrition was monitored when appropriate to help ensure they had sufficient to eat and drink.

There was an open door policy and a positive culture in the service. Staff were comfortable to approach the registered manager for advice and guidance and felt able to raise concerns or issues as necessary. They told us they were listened to and action was taken promptly when required.

People were asked for feedback on the quality of the service they received and they were provided with information on how to make a complaint.

The quality of the service was monitored through regular feedback from people, staff and stakeholders. A system of auditing allowed the provider and registered manager to keep a clear view of the quality of the service provided. They used this information to plan and make improvements.

This inspection was carried out by a single compliance inspector. At the time of our inspection the service was providing care and support to 40 people in their own homes. Many of the people supported by this service suffer with dementia and we were only able to speak personally with two people. We also spoke with four relatives of other people who use the service.

The summary is based on these conversations, our observations during the inspection, speaking with the registered manager and from looking at records. In this service, staff who provide care to people are known as support carers and we also spoke with four of them.

If you wish to see the detailed evidence supporting our summary please read our full report.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

Is the service safe?

People were protected from the risk of inappropriate or unsafe care. This was because the provider had effective systems in place to assess, plan, review and monitor the care and support provided to people who use the service. In addition procedures were in place to identify, assess and manage risks to the health, safety and welfare of people and others in relation to activities and incidents. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Relatives of people who use the service were confident the provider maintained people’s safety. One relative told us “I know that my relative feels safe and we both have confidence in the carers to do what is right for them. I have no anxiety at all about the arrangement at all”. People confirmed they felt secure in the service. One person said, “I have never had any concerns at all about my safety. I know these people and they always take the very best of care of me”.

Safeguarding procedures were robust and staff understood how to safely care for people they supported. Staff had received appropriate training to deal with minor injuries. They had been provided with personal copies of a guidance manual which included guidance on maintaining the health, safety and welfare of people in the event of an emergency.

We found that the service recruitment policy had been adhered to. This meant that the provider had taken proper steps to ensure that suitable staff were recruited by this service and had appropriate skills and experience for the role.

The registered manager told us, “Looking after people who are vulnerable in some way is a very responsible job. I only recruit and keep the best staff and I have great trust and confidence that they will keep our people safe above all”.

Is the service effective?

People’s care needs were assessed with them and their relative or representative where appropriate. We noted that care plans were detailed, had been regularly reviewed and reflected people’s care and support needs and goals.

All staff had received training to meet the needs of the people who use the service. Examples of training included infection control, the safeguarding of vulnerable adults (SOVA), safe moving and handling, the Mental Capacity Act 2005, first aid, fire safety and dementia awareness.

We spoke with two people and four relatives of people who use the service. They were complimentary about the care received. One person we spoke with said, “On Sundays one of them takes me to the Church once they have finished getting me ready. They really do brighten my day”. It was clear from our conversations that staff has a good understanding of people’s care needs and were committed to providing quality care.

Is the service caring?

People told us they were supported by kind and caring staff who promoted people’s independence and upheld their dignity. One person said, “I see about four staff regularly and they are all very kind and professional. They provide care in a way that causes me no embarrassment or anxiety whatsoever”.

Relatives confirmed the caring approach staff took with people they supported and in communicating with relatives. One said, “We have never had a problem because the communication with the manager has always been first class. They are very interested and caring”.

In conversation with staff one of them told us, “The best part of the job is being able to help the people to be as independent as possible for as long as they can be. I love the interaction and the stories they tell”.

Is the service responsive?

The service had a number of effective formal systems in place to monitor care quality including the support plan review process, the accident and incident recording process and complaints and comments.

Staff meetings were held to discuss care issues and related matters. The provider regularly sought feedback from people and relatives in the form of customer satisfaction surveys. The registered manager told us, “We have good staff and I think the company is really finding its feet now. Most importantly, I know that people are happy with the care because they tell me constantly. We also have a number of thank you letters from people and their relatives”.

Both people that we spoke with confirmed that they had regularly been asked for their views about the care and support they had received. One person said, “I did have one small problem on one occasion. I mentioned it to the manager and they resolved it the same day and I could stop worrying about it”.

One relative that we spoke with told us, “I have not been asked to provide written feedback to the company yet as we’ve only been using them for a short time. When I do it will be very positive. The manager is on the ball and they seem to communicate very well with us and each other”.

Is the service well-led?

The registered manager demonstrated a thorough knowledge of their role and the care and support needs of people who use the service. During our inspection they were accessible to people, relatives and staff.

Records were well maintained and easy to locate and navigate. Records we reviewed showed that relatives and members of the community were complimentary about the service and its staff and manager. Quality monitoring procedures were effective and staff appeared caring, dedicated and professional. One of them said, “I think I work for a great company. It’s very well led and responds quickly to any problem that interferes with people’s care”.

There were systems in place to ensure people who use the service and their relatives could provide feedback to the provider about the quality of the service received. People and their relatives were confident that when concerns were raised these had been addressed.