Care One 2 One
23 Bartlett Street, Caerphilly, CF83 1JS
Tel: 029 20850211
Email: aprice.careone2one@gmail.com
Contract Monitoring Report
- Name of Provider: Care One 2 One
- Date of Visit: Wednesday 29 March, 2023, 11.30 a.m. – 2.45 p.m, Thursday 15 June, 2023, 2.00 p.m. – 4.30 p.m.
- Visiting Officers: Andrea Crahart, Contract Monitoring Officer
- Present: Alison Price, Responsible Individual
Background
Care One 2 One provide domiciliary care services in the Caerphilly Borough area, in addition to a neighbouring authority. At the time of the monitoring visits the care agency were providing 528 hours and supporting 80 individuals.
The range of care and support tasks undertaken by Care One 2 One includes personal care (e.g. assistance in bathing, washing, dressing, medication intake, personal care), nutritional care (e.g. assistance with eating and drinking, food and drink preparation, and food and drink intake monitoring), mobility care (e.g. assistance with getting in and out of bed, general movement). The provider also provide domestic services to individuals who pay privately for this service.
The Responsible Individual (RI) is registered with Social Care Wales (the workforce regulator) and there is currently a vacancy for a Registered Manager role.
Feedback is collected on a regular basis (from social workers/other visiting professionals etc.) and over the previous year there have been concerns and issues which had been brought to the Responsible Individual’s attention who had addressed them accordingly.
Dependent on the findings within the report, the agency will be given corrective and developmental actions to complete. Corrective actions are those which must be completed (as governed by legislation etc), and developmental actions are good practice recommendations.
Previous Corrective Actions
The previous Corrective Actions that had been issued during the last monitoring visit in 2022 were re-visited to track progress with these.
Written references to always be sought from the previous employer, and if there are difficulties in obtaining to include an audit trail of communications. For character references to be sought from the most appropriate person. In terms of the file viewed during the monitoring visit (MH), for appropriate references to be sought. Timescale: Immediately and ongoing. RISCA Regulation 35. Action met
Contract of Employment and offers of appointment letters to include the correct description for the job being applied for. Timescale: On going. RISCA Regulation 35. Action met.
Supervision sessions to be signed up to by both parties on all occasions. Timescale: On going. RISCA Regulation 36. Action met.
Supervision matrix to be brought up to date. Timescale: Within one month. RISCA Regulation 36. Partially met.
The training matrix to be updated to ensure that all courses attended by staff are recorded/planned for, and training certificates placed on files for all courses attended. Timescale: Within 2 months and on going. RISCA Regulation 36. Action met.
DBS information contained on the spreadsheet, particularly renewal dates to be noted so that checks can be made as to the status at any given time and DBS’s applied for in a timely manner. Timescale: Immediately and ongoing. RISCA Regulation 35.
Daily Records to reflect how medication is being given i.e. either prompted or administered.
Carers may require additional medication training/supervision/spot checks to ensure their understanding of this, and to note that this was an action requested previously. Timescale:
Within 3 months. RISCA Regulation 21. To be checked on future visits.
Developmental
Healthcare Professional inductions to be further developed to include what exactly has been covered and agreed to within the induction documentation. Timescale: Within 3 months. Action met.
Responsible Individual
The Responsible Individual (RI) for the service is Ms. A. Price. There is an expectation as part of this role that the RI will monitor the performance and quality of the service, and that this information is documented within a quarterly report in addition to a 6 monthly Quality Review. The RI had written regular quarterly reports with evidence of a robust analysis of the service and any key areas were identified for improvement. A six monthly quality assurance review had been completed up to February 2023.
The provider’s Statement of Purpose had been updated in January 2023 so therefore was current. There is an expectation that this document is reviewed on an annual basis and updated following any changes to the service.
The contingency plan should the RI and/or Registered Manager be absent would be that the Finance manager would cover the service in the interim.
The Providers’ mandatory Policies and Procedures were provided as part of the monitoring process e.g. Safeguarding, Training and Development, Complaints etc. and all were present. Policies were comprehensively written, however were all due to be reviewed in January 2023 so were currently out of date.
Care and Service Planning Process
Care One 2 One use a ‘Nurse Buddy’ electronic system which is used to plan calls to service users, store pertinent information about the person, for calls to be monitored for lateness etc, and for staffing information to be stored. The system can be accessed via electronic devices e.g. iPads and mobile phones which makes it convenient for staff to access the system out of hours and on weekends etc.
Two service user files were viewed. The paper files contained records such as a Caerphilly
County Borough Council (CCBC) Care Plan and Integrated Assessment, in addition to the provider Care Plan. Most of the documentation is stored on the electronic system.
The initial assessment for both individuals were viewed and included information relating to the person’s life history, hobbies/interests and preferences etc.
The CCBC Care and Support Plan describes the package of care that is to be delivered, and it was evident that the information required had been transferred to Care One 2 One’s Personal Plan (Service Plan).
The Personal Plans viewed appeared to be detailed and personalised and covered the needs specified in the CCBC care plan. There was sufficient information to allow carers to deliver the required level of care to individuals.
Daily records are recorded electronically via mobile phones and there is currently a paper record of these entries kept in the person’s home. The daily records viewed were detailed, and the system allows for staff to notify the office staff of any issues which need to be raised during a call. The monitoring officer was informed that Daily records and the electronic system of recording are audited by office staff to ensure that the information collected corresponds with what the package of care should be delivering.
Planned call times were compared to actual call times for two individuals over a 2 week period and indicated that call times were consistent, however there were many different health care professionals calling to individuals.
Call Monitoring
The Nurse Buddy system was viewed to ensure that sufficient travel time had been built into the call runs and it was evident they had, however there had been an occasion recently where there was an emergency relating to a service user which caused the co-ordinator to need to arrange urgent cover which impacted upon the rota for the day.
Health care professional related questions
Two health care professionals were spoken to for feedback relating to their roles in Care one 2 one. Both individuals confirmed that the office staff are helpful and supportive and that the induction training they had received was very thorough.
Support Plans (Care Plans relating to service users) are downloaded onto the electronic Apps and these are able to be accessed and reportedly clear to understand. One of the health care professionals expressed how really rewarding the role is and how she enjoyed being able to care for people, and how it was positive to be able to promote people’s independence as far as possible. This person was keen to progress in care and was willing to undertake further training to make this possible.
Staff related documentation
Four staff files were viewed which were well organised, with sections and a file index at the front of the file. However, two of the files were examined more closely to see the recruitment checks that had taken place. These files included e.g. 2 references, a signed Contract of Employment, application form/CV, and an interview record. The interview included many suitable questions for the candidates to respond to. However, it was uncertain if the references had been taken via the telephone as opposed to being written/via email. Other information present included a photograph, evidence that a Disclosure and Barring Service (DBS) had been checked, an offer of employment and training certificates.
There was evidence that a robust induction had taken place in relation to in-house procedures and policies. The contract monitoring officer is aware that as part of the healthcare professional’s induction staff watch a video that explains the role in detail, and following this staff sign up to all the areas covered in the induction. Staff also benefit from being shadowed so that they are supported in their new role.
Currently staff have undertaken training via e-learning and the certificates were filed to evidence this. Care one 2 one has made one of their office rooms into a suitable training facility where they plan to hold more face to face training for their staff. Care one 2 one delivers a range of training that is available either face to face within the company, via the Workforce Development Team in Caerphilly, or e-learning. Information relating to the face to face training that is on offer was viewed and included many visual pictures and helpful guidance.
The training matrix provided for all staff illustrated that a wide range of training is available. However, not all courses had been completed at the time of the visits, with some gaps in mandatory training noted. The training matrix did not always capture all the training that individuals had received, however the certificates verified that the person had attended the training. The training that had been attended by staff had been undertaken within the last 3 years so were up to date.
There were some gaps identified where office staff had not undertaken mandatory or non-mandatory training as part of their role, however there was evidence that some courses had been attended in recent weeks, with others planned for this year. Office staff will on occasions be required to cover calls in the community therefore are required to be up to date with their training.
The supervision matrix indicated that healthcare professionals had received supervisions at regular intervals (i.e. every three months). Supervision sessions are an important part of the role to ensure people are supported, can raise any issues/concerns and where a person can reflect on their practice. It was evident from the two files checked that the healthcare professionals had received supervisions which covered many pertinent areas of their work, however some more detail of the conversation and reference to e.g. evidence to support the logging in and out of calls to be discussed and captured. The monitoring officer was informed that supervisions had been held with management staff however the information had not been added to the spreadsheet to reflect this at this point. Appraisals are held when individuals start on the anniversary of their employment start date, but this is currently not captured within the supervision matrix, and would be going forward.
The provider undertakes spot checks and medication spot checks to ensure healthcare professionals are undertaking their roles professionally. Spot checks included checks regarding the person’s presentation e.g. whether they wore they ID badge, used PPE equipment, how attentive they were etc., in addition to checks being made regarding documentation, the environment etc. The medication spot checks ensured that the medication was being prompted or administered in line with the provider’s policy.
General
A Six monthly quality assurance review was received up to the period February 2023 which was thorough in content, and included many areas where improvements/developments can be made.
The staffing structure consists of the Responsible Individual, Registered Manager (currently vacant), Operations Manager, Finance Manager, Co-ordinator, Personal Assistant and Administration staff.
Some complaints had been received this year which mostly related to one specific healthcare professional. The areas of concern had been addressed and the person concerned had left their employment with Care one 2 one.
Care one 2 one offer permanent contracts to their staff and have introduced a pay grading system whereby staff receive an enhanced rate of pay in accordance with their social care qualification. It is anticipated that this will contribute to the recruitment and retention of staff going forward.
Care one 2 one offer many incentives for working for them e.g. a car repair scheme, loan scheme etc.
Corrective Actions/Development Actions
Appraisals for staff to be held and captured via the supervision matrix. Timescale: Within 2 months and ongoing. RISCA Regulation 35.
Supervisions and Appraisals for office staff to be undertaken on a regular basis to ensure they are supported. Timescale: Within 3 months and ongoing. RISCA Regulation 35.
Staff training (both mandatory and non-mandatory) to continue to be prioritised for all staff. Timescale: Within 3 months and ongoing. RISCA Regulation 36.
Policies/Procedures were dated January 2023 and therefore require updating. Timescale: Within 6 months and ongoing. RISCA Regulation 12.
Conclusion
Documentation viewed, for both staff and service users were stored in an orderly way, and information was easy to locate. The recruitment process for staff is robust, with just one area requiring improvement.
The training that is available to staff is comprehensive and it was evident that a lot of thought had been dedicated to the training programmes, particularly relating to the pictorial guidance.
Although some staff were out of date with their mandatory training in the early part of the monitoring process, arrangements had been made for some staff to complete further training in the meantime.
Staff receive a robust induction programme and shadowing arrangements. The interview questions that are posed as part of the recruitment process are good and include scenarios for people to answer.
The RI continues to support the branch and monitors and reviews the systems/processes on an ongoing basis.
The Contract Monitoring Officer would like to thank staff at Care One 2 One for their time and hospitality during the visit.
- Author: Andrea Crahart
- Designation: Contract Monitoring Officer
- Date: July 2023