Care service description

Smart Care is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older and younger people some of whom may be living with dementia or have a learning or physical disability. At the time of our inspection the service provided a regulated activity to 68 people.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good for Safe, Effective, Caring and Responsive but improvements were required in Well Led. The service has been rated as Good overall.

The provider had not put in place robust systems to ensure that they were aware that staff attended calls. Records were not always being maintained to ensure they were accurate and up to date.There was insufficient guidance in care plans that we reviewed around the support that people required.

Staff were not always receiving appropriate supervision that related to their role. There was insufficient records that staff were signed off as competent to deliver care. We have made a recommendation around this.

People were safe because staff were aware of the safeguarding procedure. There were sufficient levels of staff on duty to ensure that people’s needs were met. Recruitment was robust to ensure that only appropriate staff were employed.

Risks to people’s care was managed well by staff and people received their medicines in a safe way. The provider had up-to date procedures to help ensure people remained safe should there be an emergency. Staff understood how to reduce the risk of spreading infections.

Assessments of people’s needs were undertaken before they started receiving care. People were supported with their health needs and referrals were made to health care professionals where needed. People were provided with sufficient food and drinks when needed.

People felt that staff were caring, and kind and developed good relationships with them. They felt that staff treated them with dignity and were respectful towards them. People were involved in their care planning and where asked how they wanted their care to be delivered.

People told us that they would speak to staff if they had any concerns. There was a complaints procedure should anyone wish to complain and we saw that these were investigated fully.

The provider carried out other quality assurance checks to ensure people received a good standard of care. Staff consulted with outside professionals to ensure the best delivery of care.

People, relatives and staff felt that the service was well managed. Staff felt supported, valued and listened to.

The registered manager had informed the CQC of significant events including safeguarding and incidents.

Further information is in the detailed findings below.

This inspection took place on 23 June 2016 and was announced. At the last Care Quality Commission (CQC) inspection in February 2014 we found the service was meeting the regulations we looked at.

Smart Care Limited is a domiciliary care agency that provides people with personal care and support in their homes. Based in the Surrey area, the main registered office is located in Weybridge with smaller satellite offices in Farnborough and Egham. At the time of our inspection the service provided care and support to approximately 160 people. People who used the service were mostly older adults and had a wide range of health care needs and conditions. Some people were living with dementia. The majority of people receiving support were funded by their local authority but some people also pay privately for support from the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People felt safe with the support provided by the service. Staff were supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse or being harmed by discriminatory behaviour or practices. Risks to people’s health, safety and wellbeing had been assessed by senior staff. Plans were put in place which instructed staff on how to minimise any identified risks to keep people safe from harm or injury. Staff followed good practice for cleanliness and hygiene to reduce risks to people from acquired infections.

People were supported by staff that were suitable and fit to work for the service. The provider carried out employment and criminal records checks on all staff. The majority of people told us they had no concerns about staff turning up late or missing a scheduled visit. This indicated there were sufficient numbers of staff available to support people. Staffing levels were monitored by senior staff to ensure people’s needs could be met at all times.

Staff received relevant training to meet people’s needs. Senior staff monitored training to ensure staff skills and knowledge were kept up to date. Staff received supervision so that they were appropriately supported in their roles to care for people. They had access to specialist advice and support for safe medicines administration and for supporting people living with dementia.

People were involved by staff in discussions about their care and support needs. Each person had a support plan which set out for staff, their needs and preferences for how they wished to be cared for and supported. People said staff met their needs. Staff demonstrated a good understanding of how people’s needs should be met. They supported people to engage and pursue activities and personal interests to promote their overall wellbeing and reduce the risks to them from social isolation. Senior staff reviewed people’s care and support needs regularly to ensure staff had up to date information about people’s current care and support needs.

Where the service was responsible for this, people were encouraged to eat and drink sufficient amounts to support them to stay healthy and well. Staff supported people to take their prescribed medicines when they needed these. Staff monitored people’s general health and wellbeing. Where they had any issues or concerns about this they took appropriate action so that medical care and attention could be sought promptly from the relevant healthcare professionals.

The provider had clear goals and objectives about what people and their carers should expect from staff and the service in terms of standards and conduct. The majority of people were satisfied with the care and support they received. People knew how to make a

We visited Smart Care Weybridge to look at the care and welfare of people who used the service. We spoke with 25 people who used the service or their relatives. We spoke with 11 members of staff, including the registered manager. We also sent questionnaires out to people who used the service and received 28 responses.

All of the people we contacted were happy with the service. One person told us “They have been really helpful, far beyond what I thought they would do.” Another person told us “This is a brilliant service. They always go that extra mile and I can relax knowing my relative is well cared for.”

People told us that staff asked their permission before they did things for them. One person said “They always ask me if I am happy with what they are doing. No one makes me to do things I don’t want to do.”

People received care and support that met their needs. All the people we spoke with felt their care needs were met. One person told us “They are absolutely first class; they put a lot of other companies I have used to shame.”

Staff understood their roles with regards to cleanliness and infection control. People who used the service told us that staff wore gloves and aprons when they provided personal care.

The staff we spoke with said they felt supported in their roles. They received training and supervision to enable them to provide good quality care.

The manager had regularly sought the views of people to ensure they were happy with the service.

As part of the inspection we spoke with three people who used the service and three relatives of people. We also spoke to four members of staff.

The people we spoke with all told us that they felt the care they received was good and that they had been fully involved in their care plans. One person told us “The staff are very good, they are all willing to do what you need.” Another person told us the service was “Absolutely first class.”

The relatives of the people who used the service told us that they felt the people who used the service were safe in the staff’s care and that they were treated with dignity and respect. One relative told us that the staff were “Absolutely brilliant” whilst another said “The service listen to me when I have a concern.”

We found that appropriate checks were undertaken before any member of staff started work at the service. We looked at staff files and spoke to staff who confirmed this.

The service had systems in place to monitor the quality of the service and to identify when things needed to be improved. We saw that this included sending questionnaires to people and relatives and to gather their views of the service.