Pride in Care
Unit 7, Woodfieldside Business Park, Pontllanfraith, Blackwood. NP12 2DG.
Tel: 01495 221666
Email: andrew@prideincare.com
Contract Monitoring Report
- Name/Address of Provider: Pride in Care, Unit 7, Woodfieldside Business Park, Pontllanfraith, Blackwood, Caerphilly, NP12 2DG.
- Date/Time of Visit: Friday 2 February, 2024, 9.30 a.m. – 1.00 p.m. Friday 23 February, 2024, 9.30 a.m. – 12.15 p.m. Tuesday 5 March, 2024, 10.00 a.m. – 11.00 a.m.
- Visiting Officer(s): Andrea Crahart, Contract Monitoring Officer, Caerphilly CBC
- Present: Andrew Baker, Registered Manager / Marcus Hobbs, Responsible Individual (23 February visit)
Background
The range of care and support tasks undertaken by Pride in Care include personal care (e.g. assistance in bathing, washing, dressing, taking medication and intimate personal care needs), 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) to be provided in a personalised manner, ensuring that individuals have interaction, companionship and stimulation from the care and support provided.
At around the time of the visits to Pride in Care the provider was providing 963 hours to 82 different people in the Caerphilly borough area.
Over the previous year some issues have been received, including some safeguarding concerns, however all the issues have been addressed by the provider appropriately. During 2022 the provider was in the Provider Performance process that was led by the Commissioning Team of Caerphilly County Borough Council. The necessary improvements were evidenced during this time and in June 2023 this process was closed. Positive feedback has been received during this time and more recently also, although some other concerns/issues have been received.
An inspection by CIW (Care Inspectorate Wales) was carried out in September 2023 which did not highlight any areas for improvement and previous Priority Action Notices (PAN’s) had been closed.
Dependent on the findings within the report the provider 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/Developmental Actions
Corrective/Developmental
Service user Person Plan reviews to be held on a quarterly basis to ensure they are up to date and relevant. Timescale: Immediately and ongoing. RISCA Regulation 16. Action met.
Staff to be registered with Social Care Wales (the workforce regulator). Timescale: Within 6 months and ongoing. RISCA Regulation 35. Partly met/Remains ongoing.
Staff recruitment process to be re-visited to ensure it is more robust (reference requests, identifying gaps in employment, Contracts of Employment, DBS check information to be on individual files). Timescale: Immediately and ongoing. RISCA Regulation 35. Action met
On going spot checks with carers, refresher training to be rolled out (particularly medication) and other training to be undertaken where there are gaps. Timescale: Immediately and ongoing. RISCA Regulation 36. Action met.
Responsible Individual
Within the Regulation and Inspection of Social Care (Wales) 2016 Act (RISCA) this places an expectation on the Responsible Individual (RI) to oversee the service and produce written reports of their findings relating to the performance and quality of the service. Quarterly reports had been written over the previous year and a 6 monthly Quality Review, which identified issues and actions going forward, many of which related to maximising the use of the electronic system in place.
In the absence of the RI and Registered Manager the contingency plan would be that the Finance Manager would step in and cover the service.
The providers policies and procedures were viewed as part of the monitoring visits and indicated that the majority had been reviewed, however there were some slight amendments to be made to some policies to ensure they were up to date.
Registered Manager
The Registered Manager is registered with Social Care Wales (the workforce regulator).
Call Monitoring
The provider uses an electronic monitoring system named ‘Birdie’. This requires the use of mobile phones where carers swipe in and out of calls so that an electronic log of these is captured and carers record the tasks they have performed at each call via the use of this system. The benefits of which are that the office staff can see in ‘real time’ what care and support has been delivered and at what times.
The system will also provide an electronic record to alert if calls are late, or potentially missed. When alerts are received staff can be contacted to ask if they are on their way, and if necessary other arrangements can be made to cover the call, and inform the person concerned accordingly. These mobile phones also have additional features i.e. important contact numbers etc.
The provider can download reports from the electronic call system to track how well carers are performing in booking in/out of their calls etc. and performance is discussed during carer supervision sessions.
Care and Service Planning Process
Two service user files were examined as part of the monitoring process.
Information could be located on the Birdie electronic system in relation to their Personal Plans (Care Plans), manual handling plans (where appropriate) and CCBC Care Plan information. The tasks that had been performed and captured on the Birdie system correlated with the needs outlined in the Personal Plans. The person’s preferred call times had been captured on the system and there was some background information about each person (family background, previous work history, what they enjoyed etc.)
Carers are able to capture the tasks they are performing during each call and add additional information via an ‘observations’ screen e.g. the amounts individuals are eating/drinking, how the individual is presenting during the visit etc.
Rota planning was examined and it was evident that actual call times were largely close to the planned call times for the individuals concerned, however some of the call times were not sufficiently spaced apart for the one person, with the lunch and the tea call being planned too close together. This information was brought to the attention of Pride in Care during the visit.
Travel time had been built into the runs, although there were some that were highlighted during the visit. The RI confirmed that they were aware of the situation with one of the runs and were addressing this with the carer resources they would soon have.
The care packages had been reviewed at regular 3 monthly intervals and Pride in Care continue to develop the Birdie system to accommodate additional review information.
Staff related documentation
Two staff files were viewed. The files included a recruitment checklist, application forms, where there were no gaps in employment identified; an interview record, suitable ID (birth certificate, driving licence), 2 written references, a contract of employment and Disclosure and Barring Service (DBS) information. Further information is required to be captured in terms of the DBS i.e. the date of issue and whether it was clear or not, and one of the Contracts of Employment omitted to include the person’s start date and probationary period.
Staff training continues to be facilitated by the provider’s in-house trainer, who conducts courses on the premises. A training matrix was provided that indicated mandatory training was being undertaken. Some of the courses were discussed during the visit and the manager confirmed that moving and handling and medication training are being increased in regularity so that staff receive a refresher more frequently. The provider regularly deliver training relating to catheter care, stroke awareness, food hygiene, sensory impairment and dementia care, however these courses are not clearly reflected on the training matrix. The RI confirmed that this was a piece of work he planned to review to ensure the matrix illustrated all of these courses to the reader.
Although one of the files indicated that a shadowing process had been started for the carer there were no records to indicate that this had occurred. The Contract Monitoring Officer was informed that this documentation was being developed, furthermore additional shadowing records were requested for newer carers but these were not forthcoming. Less than half of the staff team have registered with Social Care Wales (the workforce regulator) at the present time, however Pride in Care are ensuring that staff are supported to do this via their office team.
Staff are supported in their roles via formal supervision sessions, which should take place on a quarterly basis. It was evident from the supervision matrix that some staff had received supervisions. Spot checks are also required to ensure that staff are undertaking their roles to the required standard, and although these were taking place they were not for all staff.
Pride in Care reported that recruitment had improved in recently weeks and that this would enable the agency to take on additional packages of care (when they are available), enable training to take place and for new runs to be created on the rotas which will enable more capacity.
A team meeting had been held in July 2023 for the carers and another for the office staff to share information to the staff team. Typical topics included e.g. recruitment, roles/responsibilities, confidentiality, ensuring professionalism, actions to take forward for office staff etc. However, no further meetings had been documented since this date.
Care and service user feedback
Carers were spoken to as part of the monitoring process to obtain their feedback. A carer indicated that they always have sufficient travel time in between calls and are able to stay the full duration of the calls, another stated that on occasions there is too much time in between calls and other time insufficient time. Carers confirmed that they are supported by the manager/team, they had received an induction and shadowing had taken place when they initially were appointed. One of the carers was asked about the electronic Birdie system who confirmed that it was a really good user friendly system and that there was good detail on the Personal Plans/Risk Assessments to enable them to undertake the tasks needed. A carer offered that communication is good with the office and that any issues are resolved for them.
A number of service users were contacted for their feedback about the service they receive and in the majority of cases people were happy with the care and support they receive. In the majority of cases carers were calling at the correct times. Carers were described as being ‘very good’ and some confirmed that they were ‘lovely and always had a smile on their face’. There were no concerns relating to the tasks that they performed and in most cases carers always wear their uniform and their ID badge. Although other feedback indicated that carers were frequently late, that they do not receive a telephone call to let them know when they will arrive, and there is often a lack of carer consistency.
General
Pride in Care are looking to make links with other voluntary organisations who can improve people’s wellbeing, and this is being done by linking with Age Cymru to see what support they can provide to the service users who are cared for by the agency.
The current staffing structure consists of the Responsible Individual, Registered Manager, Finance Manager, 4 Team Leaders (with 3 currently being trained), 2 Care Co-ordinators, a Training Co-ordinator and approximately 70+ carers.
Fifty four carers had left the agency during 2023 and to date this year. The majority had left due to moving to another position elsewhere, with a few leaving for other reasons e.g. failing their probation, moving to further education, decision taken not to take up the role offered etc.
Recommendations
Supervisions, appraisals/personal development plans and spot checks to be undertaken and planned for on a quarterly basis. Timescale: Within 3 months and ongoing. RISCA Regulation 36.
To ensure that catheter care, stroke awareness, food hygiene, sensory impairment and dementia care/mental health training are clearly identified on the training matrix. Good practice guidance states that these courses are to be refreshed on a 3 yearly basis. Timescale: Within 3 months. RISCA Regulation 35.
SCW registration processes to continue to ensure all carers are registered. Timescale: ongoing. RISCA Regulation 35.
Shadowing process to be in place and evidenced for every newly appointed carer. Timescale: Immediately and ongoing. RISCA Regulation 36.
Policies/Procedures – Safeguarding and Staff Support/Development to be reviewed again to ensure all information is up to date. For review dates to accurately reflect the date they have been reviewed. Timescale: Within 3 months. RISCA Regulation 16.
Team meetings to be held more frequently i.e. 6 times a year. RISCA Regulation 38.
Conclusion
Documentation on the electronic Birdie system appeared to be robust and was reflective of the needs of the service users records viewed. The system is continually being developed to ensure all information is contained and accessible in one place and issues that arise with packages of care can be addressed sooner.
Further attention is needed to be given to call times to ensure that the specified preferred call times are adhered to as far as possible; communication is made with service users/families where changes need to be made; that sufficient time is built into the runs to allow time for carers to arrive at their destinations by the correct time, and for telephone calls to be made to reassure people where there is lateness.
Staff files were orderly and the majority of the information required had been captured. Pride in Care intend uploading all recruitment documentation and supervision documentation to the Birdie system for easy access.
Although there was evidence that supervisions and some spot checks had been undertaken staff appraisals were lacking, however it is evident that these are being planned for.
Pride in Care have successfully met all the Priority Action Notices that had been issued by CIW in 2023.
The Contract Monitoring Officer would like to take this opportunity to thank the managers for their time and hospitality during the visits.
- Author: Andrea Crahart
- Designation: Contract Monitoring Officer
- Date: March, 2024