DOMICILIARY CARE AGENCY

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1 DOMICILIARY CARE AGENCY Manchester Care 2 nd Floor, Victoria Mill 10 Lower Vickers Street Miles Platting, Manchester M40 7LJ Lead Inspector Sue Jenning Announced 28 June 2005

2 The Commission for Social Care Inspection aims to: Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from (telephone order line) Copyright This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Internet address

3 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this agency are those for Domiciliary Care. They can be found at or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: Online ordering: This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Manchester Care Version 1.40 Page 3

4 SERVICE INFORMATION Name of service Manchester Care Address 2 nd Floor, Victoria Mill 10 Lower Vickers Street Miles Platting Manchester M40 7LJ Telephone number Fax number address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration Manchester Care Ltd Mr Huw John Christine Barry Domiciliary Care Agency No. of places registered (if applicable) Category(ies) of registration, with number of places Domiciliary Care Agency Manchester Care Version 1.40 Page 4

5 SERVICE INFORMATION Conditions of registration: 1. The agency povides a service to adults only. 2. The agency must at all times employ a manager who is registered with the Commission for Social Care Inspection. Date of last inspection N/A Brief Description of the Service: Manchester Care Ltd Domiciliary Care Agency are based in offices in the Miles Platting area of Manchester. The agency is part of the Manchester Care Ltd group which is a non-profit making organisation. The office is situated on the second floor of Victoria Mill and is fully accessible to anyone visiting the agency. Access to the second floor is via a passenger lift. There is a reception area with seating available and visitors to the office are asked to sign in and out. The premises are suitable for the size and scope of the agency and is equipped with a telephone system which includes an out of hours transfer system, a fax machine, PC's and a photocopier. The agency provide a domiciliary care service for adults living in their own homes or in supported housing schemes in and around the Manchester, Trafford and Oldham. An extra care service is provided in St Helens and Tameside areas. This service supports individuals within a community based scheme to live as indepenantly as possible. The agency also provides support to service users requiring intermediate care in partnership with the local Primary Care Trust (PCT). Manchester Care Version 1.40 Page 5

6 SUMMARY This is an overview of what the inspector found during the inspection. This was the agency s first announced inspection since registering as a domiciliary care agency with the CSCI. A day was spent at the agency s office talking to the owner, manager and administration staff as well as looking at files, policies, procedures and other relevant records. In addition four people who use the service were spoken to over the phone to find out what they feel about the service they receive. Further views were gained through sending a questionnaire to a random selection of people who use the service and care staff. During this inspection only a selection of the key National Minimum Standards were assessed therefore in order to gain the full picture of how the agency meets the needs of the people who use the service this report should be read with the previous and any future reports. What the service does well: The manager or one of the team managers usually visits people in their own homes to undertake pre-service needs assessment and environmental risk assessments. This means they are able to gather all the information they need about a person to be able to provide the appropriate support. It also gives the person an opportunity to ask questions and to get to know the agency better. The manager believes that it is important to build a good relationship with the person and/or their family. One person said, if I have any concerns I just speak to them at the office all the staff are very nice they are very good I have no problems at all. People who made comments about the agency said that the staff treated them with respect. Several people mentioned that staff usually arrived on time and that they were notified of any alterations due to holidays or sickness. One person said if they are going to be late they usually ring up to let me know. Service users said that staff were smart and carried an identification badge. One person said that staff were patient and helpful. The manager said that there was regular contact between the team leaders based in the office the service user and support workers. This meant that any problems were identified and acted upon quickly. One person said that any concerns were dealt with straight away. Another area where the agency does well is in its understanding of how people can be vulnerable living in their own homes. Manchester Care Version 1.40 Page 6

7 The manager, team leaders and care staff showed a good understanding of Adult Protection procedures. This was further evidenced during a discussion with a team leader who talked about a particular incident where care staff had identified an area of concern, which was quickly acted upon using the Manchester Adult Protection Procedures. The member of staff said I was very concerned about the situation and felt reporting it through the Manchester Multi Agency Policy for the Protection of Vulnerable Adults was the right thing to do. The agency also has links with the intermediate care team based at Kirkley Residential Care home. People were referred to the agency for intermediate homecare for a set period usually no longer than 6-weeks either because their previous setting had broken down or they were being discharged from hospital. Referrals were received from either the intermediate care unit or the hospital. During this period Occupational and Physiotherapy support is also available. The North and Central Primary Care Trusts fund the period of Intermediate care so there is no cost to the person. During the six-week period people were assessed to see if they needed a more long-term care package. This service ensured that people who may previously have gone into residential care or long-stay hospital can return to their own homes. If service users require a long-term care package a financial assessment is carried out to establish how the cost of the care will be met. What has improved since the last inspection? This is the agency s first inspection and so the progress of those areas identified as needing improvement will be looked at throughout the coming 12 months What they could do better: The agency provided a service to a number of different local authorities. The agency had a policy and procedure relating to the Protection of Vulnerable Adults, however, this document did not refer to the procedures in all of the authorities covered. The complaints procedure included in the initial referral pack did not provide details of the Commission for Social Care Inspection. People should be informed that they are able to contact the Commission at any time. Manchester Care Version 1.40 Page 7

8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from or by contacting your local CSCI office. Version 1.40 Page 8

9 DETAILS OF INSPECTOR FINDINGS CONTENTS User Focused Services (Standards 1 6) Personal Care (Standards 7-10) Protection (Standards 11-16) Managers and Staff (Standards 17-21) Organisation and Running of the business (Standards 22-27) Scoring of Standards Statutory Requirements Identified During the Inspection Version 1.40 Page 9

10 User Focused Services The intended outcomes for Standards 1 6 are: 1. Current and potential service users and their relatives have access to comprehensive information, so that they can make informed decisions on whether the agency is able to meet their specific care needs. 2. The care needs requirements of service users and their personal or family carers when appropriate, are individually assessed before they are offered a personal domiciliary care service. 3. Service users, their relatives and representatives know that the agency providing their care service has the skills and competence required to meet their care needs. 4. Each service user has a written individual service contract or equivalent for the provision of care, with the agency, except employment agencies solely introducing workers. 5. Service users and their relatives or representatives know that their personal information is handled appropriately and that their personal confidences are respected. In the case of standards 5.2 and 5.3, these do not apply to employment agencies solely introducing workers. 6. Service users receive a flexible, consistent and reliable personal care service. In the case of standards 6.3 and 6.4 these do not apply to employment agencies solely introducing workers. The Commission considers Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 1, 2, 4, and 5 The agency produced clear and comprehensive information and carries out a pre-service assessment that provides a flexible, consistent and reliable service designed to meet individual needs. This ensures that prospective service users are able to make an informed decision. EVIDENCE: The manager stated that although a Care Management assessment was provided one of the Care Co-ordinators would visit the person in their own home to carry out a pre-service assessment. Version 1.40 Page 10

11 During this visit an environmental risk assessment is also undertaken. Each person receives a copy of this assessment and a statement of the support to be provided that is held in the file kept at his or her home. This means people are fully aware of the assessment process and are involved in the planning of their care. A Service User Guide was held in each person s home along with the care plan and a daily record. Care staff, were able to identify and report any significant changes, which may affect the person s health and wellbeing. People spoken to said that they had met with their carer before the service started and this made them feel more at ease about receiving a service. Comments received from people who use the service demonstrated that they receive a consistent, flexible and reliable service. Care Co-ordinators regularly monitor the service provided. One service user said they always arrive on time and they could rely on them. For those people funded by a local authority there was a three-way contract between the person, the local authority and Manchester Care Ltd. A contract is provided to those people who pay for their own service. The agency had a policy relating to confidentiality, which detailed the responsibilities of staff. All staff are required to read and sign a commitment to confidentiality agreement in line with the DATA Protection Act 1998 and a copies of this was seen on personnel files. The importance of confidentiality was discussed during the induction period and was also referred to in the staff handbook. This ensured that people s privacy and dignity were maintained. There was evidence of a recent quality assurance review of the service. Although the information had not been analysed the comments were discussed. The agency carried out a random sample of forty-one people who were asked a number of questions relating to the service they received. When asked if the carer arrived on time 39 out of the 41 people surveyed said yes, when asked about the carers appearance 41 said that the carer was always smart and had a patient and understanding attitude. All of the people surveyed said that they were satisfied with the way carers carried out tasks. Version 1.40 Page 11

12 Personal Care The intended outcomes for Standard 7 10 are: 7. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan, except for employment agencies solely introducing workers. 8. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. 9. Service users are assisted to make their own decisions and control their own lives and are supported in maintaining their independence. 10. The agency s policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves. In the case of standards 10.8 and 10.9, these do not apply to employment agencies solely introducing workers. The Commission considers Standards 8 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 7 and 8 The agency worked with people and their representatives to record their goals and support needs and provided staff with the skills and knowledge to meet assessed needs. People were treated with respect whilst maintaining their dignity and independence. EVIDENCE: The agency held a file relating to each person this included a copy of the preservice assessment the Care Management assessment of need and care plan. The care plan included nutritional, falls, and moving and handling risk assessments and identified the action needed to meet the assessed needs. The care plans were agreed with and signed by the person and or their representative. Evidence was seen of the involvement of the person and or their representative in the drawing up of the plan of care. Version 1.40 Page 12

13 There was evidence to demonstrate that care plans are reviewed on an ongoing basis and changes made where required. The agency had a medication policy, which was under review at the time of inspection. The medication policy gave clear instructions on how to support people in taking their medication. The agency provides an extra care service that supports tenants within a community-based scheme to live as independently as possible with access to support services. Support staff working in the extra care services are trained to administer medication. The agency s homecare staff are currently only able to prompt medication from a monitored dosage system. There are however, plans to review the range of responsibilities of home carers who are currently only able to prompt people to take their medication. The more advanced training will enable home carers to administer medication to people. The medication policy will be examined further during the next inspection. Version 1.40 Page 13

14 Protection The intended outcomes for Standards are: 11. The health, safety and welfare of service users and care and support staff is promoted and protected, except for employment agencies solely introducing workers. 12. The risk of accidents and harm happening to Service Users and staff in the provision of the personal care, is minimised, except for employment agencies solely introducing workers. 13. The money and property of service users is protected at all times whilst providing the care service, except for employment agencies solely introducing workers. 14. Service users are protected from abuse, neglect and self-harm, except for employment agencies solely introducing workers. 15. Service users are protected and are safe in their home, except for employment agencies solely introducing workers. 16. The health, rights and best interests of service users are safeguarded by maintaining a record of key events and activities undertaken in the home in relation to the provision of personal care, except for employment agencies solely introducing workers. The Commission considers Standards 11, 12 and 14 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 11, 12, 14 and 15 The agency had policies, procedures and systems in place to fully protect the health, safety, money and welfare of people and to ensure people are safeguarded from abuse. EVIDENCE: Environmental risk assessments are carried out this included an assessment of equipment within person s homes, which staff may need to use. This would include hoists, vacuum cleaners, irons, kettles and toasters. The agency was aware that it had responsibility to ensure that any equipment used by staff had to be regularly serviced. Version 1.40 Page 14

15 During the induction period all staff undergo training in relation to Moving and Handling, Health and Safety, Controls Of Substances Hazardous to Health (COSHH) and Basic Food Hygiene. The manager reported that Health and Safety issues were discussed during job consultations. The agency has a policy relating to failed visits, staff are expected to complete a form for each visit where they failed to gain entry. This enables the agency to alert the Care Manager and establish the reason for failed visits and reassess the care package if necessary. The agency had a policy and procedure for supporting people with their personal finances. Any financial transactions made on behalf of the person using the service were recorded at the person s home and returned to the main office on a weekly basis. Thus ensuring there is no mishandling of peoples finances. The agency had clear procedures in place for the reporting of incidents that may be abuse using the Manchester Multi-Agency Adult Protection Procedures. This was evidenced in discussions with a Care Co-ordinator who provided details of a recent incident when carers expressed concerns regarding the safety of a person using the service. The local Adult Protection Procedures were invoked and appropriate action taken to protect the service user. Staff involved in this incident demonstrated an awareness of their responsibilities and acted appropriately to ensure the safety of a person using the service. Version 1.40 Page 15

16 Managers and Staff The intended outcomes for Standards are: 17. The well-being, health and security of services users is protected by the agency s policies and procedures on recruitment and selection of staff. 18. Service users benefit from clarity of staff roles and responsibilities, except for employment agencies solely introducing workers. 19. Service users know that staff are appropriately trained to meet their personal care needs, except for employment agencies solely introducing workers. 20. The personal care of service users is provided by qualified and competent staff, except for employment agencies solely introducing workers. 21. Service users know and benefit from having staff who are supervised and whose performance is appraised regularly, except for employment agencies solely introducing workers. The Commission considers Standards 17, 19 and 21 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 17, 18, 19, 20 and 21 Overall the agency makes every attempt to safeguard people by having robust recruitment and selection procedures and a staff team who were appropriately trained and supervised. EVIDENCE: During the inspection a number of staff files were inspected. The files contained two references one being from a previous employer. The manager was aware that Criminal Record Bureau (CRB) disclosure certificates were not transferable from other agencies. The agency checked all staff against the Protection Of Vulnerable Adults list (POVA). There is a staff team that consists of the manager, five team managers, five care co-ordinators, two administrative workers and a team of 201 care workers. Version 1.40 Page 16

17 Each member of staff had a training and development plan which included details of courses attended. All staff underwent induction training and there was evidence held on file to demonstrate that staff received training in respect of Moving and Handling, Health and Safety, Basic Food Hygiene, Basic First Aid and Fire safety. A training facilitator arranges visits to service users homes in order to observe Moving and Handling practices. The agency maintained a record of mandatory training that ensures training can be updated as and when necessary. The manager reported that 7% of staff were trained to NVQ Level II and that 40 places had been allocated to staff to commence in September The manager gave a commitment to achieving the target of 50% of staff trained to NVQ Level II by The manager reported that she has developed a database of information held within the office for staff and service users to access this included data sheets about Alzheimer s disease, Bipolar Dementia, Diabetes and Motor Neurone disease. The manager reported that job consultations (supervision) took place 3 monthly. Additional meetings were arranged when required. This was confirmed in discussions with staff that said that they felt 100% supported by the manager. Staff received regular job consultations and were also able to approach the manager for advice and support at any time. The manager had the skills and experience required to undertake the role. She had recently been awarded the Diploma in Management Studies and held the Certificate in Management Studies, the Preliminary certificate in Social Care and the In Service Course in Social Care. Version 1.40 Page 17

18 Organisation and Running of the Business The intended outcomes for Standards are: 22. Service users receive a consistent, well managed and planned service. 23. The continuity of the service provided to service users is safeguarded by the accounting and financial procedures of the agency. 24. The rights and best interests of service users are safeguarded by the agency keeping accurate and up-to-date records. 25. The service user s rights, health, and best interests are safeguarded by robust policies and procedures which are consistently implemented and constantly monitored by the agency. 26. Service users and their relatives or representatives are confident that their complaints will be listened to, taken seriously and acted upon. 27. The service is run in the best interests of its service users. The Commission considers Standards 22 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 22 and 23 The agency provided a consistent and well managed service where people were able raise their concerns and their views were sought by the agency. EVIDENCE: The management structure and team size was sufficient to meet the needs of the people who use the agency. The agency operated out of Victoria Mill. The offices and facilities were sufficient to operate the size and scale of the agency. People spoken to confirmed that they were aware of the complaints process and said they would talk to the manager if they had any concerns. The agency kept a record of all complaints, any investigations and the actions taken to address them. During the past 12 months the agency had received 16 complaints of which two were partly substantiated and two were referred to POVA. Version 1.40 Page 18

19 It was noted that the complaints procedure provided to people as part of the initial referral pack did not include the role and contact details of the CSCI. The agency must ensure that this document is amended and revised copies provided to people who use the service. The agency had recently undertaken a quality assurance survey, which involved a sample of 41 people who use the agency. This was used to help establish the quality of the service provided. The information was fed back to the manager and will be published in the agencies business plan. Information received could also be used to ensure care packages continued to meet needs where it was identified that needs had changed. Relevant referrals were made to the appropriate services in order to meet people s needs. Version 1.40 Page 19

20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Domiciliary Care have been met and uses the following scale. 4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls) X in the standard met box denotes standard not assessed on this occasion N/A in the standard met box denotes standard not applicable User Focused Services Managers and Staff Standard Score Standard Score Number Number x x Personal Care Organisation and running of the business Score Standard Score Number x 24 x 10 x 25 x Standard Number Protection Standard Score Number x x 26 x 27 x Version 1.40 Page 20

21 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Domiciliary Care Regulations 2003 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action The Adult Protection Policy must reflect the local Adult Protection procedures of each local authority to whom the agency is contracted to provide a service The contact details of the Commission for social Care Inspection must be included in the complaint policy within the initial referral pack given to service users RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Version 1.40 Page 21

22 Commission for Social Care Inspection 9 th Floor, Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: Web: This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Version 1.40 Page 22

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