Cera Care
Valley Innovation Centre, Navigation Park, Abercynon, CF45 4SN.
Tel: 0333 4343094 / 01443 744474
Mobile: 07812 749770
Email: Paul.davies@ceracare.co.uk
Contract Monitoring Report
- Name of Provider: Cera Care
- Date of Visit: 24 March 2023
- Visiting Officers: Caroline Roberts, Contract Monitoring Officer
- Present: Paul Davies, Branch Manager / Natalie Jones, Care Co-ordinator
Background
In January 2020, the provider Mears Care changed its name to Cera Care. The previous contract monitoring visit was undertaken in 2019 when the business was registered as Mears Care. This is the first monitoring visit since the takeover of the business, having a new Branch Manager and the removal of Covid restrictions.
At the time of the visit, Cera Care was providing approximately 359.5 hours per week of care and support per week to 36 individuals residing within the Caerphilly Borough.
The range of care and support tasks undertaken by Cera Care includes personal care (e.g. assistance with bathing, washing, dressing, administration of medication, supporting with personal care), nutritional care (e.g. assistance with eating and drinking, food and drink preparation, and nutritional intake monitoring), mobility care (e.g. assistance with getting in and out of bed, general movement).
Dependent on the findings within the report, the provider will be given corrective and developmental actions to complete. Corrective actions are those that must be completed (as governed by the contract, The Regulation and Inspection of Social Care (Wales) Act [RISCA]) and developmental actions are good practice recommendations.
Findings
Cera Care use an electronic system for recording all appropriate information i.e. care support, risk assessments, medication administration, contact with the office etc. The system used is Digital Care Platform (DCP).
Whilst viewing three customer’s documentation, it was noted that there were no individual specified times recorded. Whilst discussing this matter, the monitoring officer was advised that when contacted by the Local Authority’s Brokerage Team, the agency provides the times they are able to offer. When agreed by the Brokerage Team, the package of care is then accepted by the agency.
It was discussed with the Branch Manager and the Care Co-ordinator, that an individuals preferred times should be recorded and retained on file. Such calls should then be me rostered as close as possible to individuals chosen timeframe.
Daily notes were examined for three individuals over a two-week period. Overall, the recordings were found to be detailed and recorded the individual’s mood, what food/drinks were prepared, what assistance was provided etc. However, the CMO has requested that the provider look at the automated detail and the terminology used.
Whilst viewing two weeks of calls for both customers, it was identified that carers for one individual had not been staying for the full amount of planned time. The provider is reminded that should it be considered that an individual requires a reduction or additional time, contact should be made with the office in order that a review may be undertaken by Social Services.
Whilst viewing a two-week period for carer consistency, it was noted that the numbers of carers attending the two individuals all met the carer continuity threshold.
Whilst it is not always possible to ensure continuity, it was evident, in the cases viewed, that Cera Care is endeavouring to ensure that the same carers visit the same customers.
Care and service planning process
Two customer files were examined during the monitoring visit. Both files contained a Social Services Care Plan and the information had been appropriately transferred over to the Individual Support Plan. All plans were found to be extremely detailed.
Should a new starter commence employment with the company, from reading the electronic documentation, the employee would know what is required of them to assist the customer. The personal plans are detailed and record how to enter the property, where the person may be located, where the care staff can locate items, to encourage independence in choosing their daily clothing etc.
When producing a Personal Plan, all providers must evidence that the individual and/or representative has assisted in its development. One plan informed the reader that it had been devised during Covid and therefore, a signature was not obtained, whilst the second plan included appropriate individuals.
Personal Plans were observed to be mainly reviewed every 3 months; however, the provider is reminded to be consistent with the 3 monthly reviews as some were noted to be out of time. All appropriate individuals were involved in the review process, during which, a variety of questions are asked about the level of service, the care staff and a rating is also requested.
The equipment used by an individual is recorded and advises the reader of when it was last inspected, by whom, who the contract is with, any risk factors for the individual and the care worker(s) operating the equipment.
Out of the three files viewed, all three evidenced that either the individual had been involved in the development of their Individual Service Plan or a family member/representative had been involved.
It was positive to note that the Personal Plans consist of a section “Getting to Know You”. This section provides the reader with a brief synopsis of the individual receiving the support i.e. life history, interests/hobbies, what is important to you, what would you like us to know in order to best support you?
Risk assessments were present for both individuals and covered a variety of areas i.e. Dementia (Health and Well-Being), Sensory Impairment, Diabetes, incontinence etc.
With DCP all calls are recorded electronically; therefore, evidencing an accurate time of the arrival of the carer(s) and their departure from the property.
Recruitment, training and supervision
As part of the monitoring process, two care staff files were examined. Both files contained interview records. During the interview process, a scoring system is used to confirm the suitability of an individual to the role.
Application forms were detailed, with no apparent gaps in employment. Both files contained current Enhance DBS (Disclosure and Barring Service). Both files contained two references, and it was positive to note that the provider had recorded the number of attempts made to contact previous employers for references.
A signed Contract of Employment was observed to be in place for both members of staff, along with photographic identification and documentation relating to carers’ vehicles i.e. MOT certificates.
Neither file held a copy of a job description.
It was noted that one staff member had completed the right to work in the UK and the right was noted to expire in 2025. The Branch Manager advised that near the time, this specific area would be addressed by the providers Compliance Team.
Training records were viewed and evidenced that mandatory and non-mandatory training is undertaken i.e. stoma care, infection control, dementia care, safeguarding, moving and handling.
Staff complete an induction in line with the Social Care Induction Framework for Wales.
The induction/probation period covers a wide range of observations from introduction to the individuals they are assisting, policy and procedures etc.
At the time of the monitoring visit, it was noted that staff supervision is being undertaken. In line with the RISCA regulations, supervision of staff is to be undertaken at least quarterly.
Spot checks and/or direct observations are undertaken and 2 were observed. In line with RISCA, a minimum of 2 are to be undertaken in a year; however, more will be undertaken by the provider should any issues arise. The purpose of the spot check is to ensure staff undertake their role as expected i.e. arriving on time, communicating appropriately, fulfilling, nutritional requirements, movement support, is the support being given with respect and dignity, appearance, ID. During the process, the customer has the opportunity to provide feedback on the service they received.
One staff member, office based, is a fluent Welsh speaker; however, at the time of the monitoring visit, it was not known how many customers speak Welsh.
The monitoring officer randomly viewed the timings allocated for carers to get from one visit to another. Whilst viewing the documentation, it was noted that appropriate travel time was given from the distance between the location of one scheduled visit to the next scheduled visit.
Staffing
Staff newly appointed are offered permanent contracts; however, this depends on the individual’s availability and their wishes. At the time of the visit, there was only one member of staff on a permanent contract, with the others requesting to remain on a zero-hour contract.
Quality Assurance
The service has recently had a re-structure and Mr Anthony Cragg is in the process of registering with CIW to become the providers Responsible Individual. Once the registration process is complete, an amended Statement of Purpose is required.
Regulation 73 reports (this is a requirement where the RI visits the service to monitor the performance of the service in relation to its statement of purpose) were viewed for the last 2 quarters. Areas covered within the report are feedback from service users, feedback from staff, sampling of staff files and customer records, process review and an action plan based on the findings.
A copy of the Statement of Purpose was provided, which highlighted when it had been last reviewed (October 2022). This will require up-dating when Mr Cragg becomes the official RI.
The contingency plan, should the Responsible Individual and the Branch Manager be absent at the same time, is that the Care Manager would become the first point of contact, there would be additional touch points with the RI and Area Manager to ensure there is a cohesive support overview in place. In the event of the RI being absent, the Regional Director and Area Manager would support with the team with day-to-day tasks, the Director for Quality would step in as a contact point of CIW and the Local Authority. All relevant CIW notifications would be completed in a timely manner when required.
Policies and Procedures are available and up to date. These are up-dated as and when changes are identified/occur.
General
Any areas of concern or late calls are highlighted via ‘Alerts’. The alerts allows the provider to act in a timely manner and resolve any issues or make contact with a customer should the carer be delayed.
A copy of the service user guide was provided, and it is recommended that the document be dated and the contact details for Caerphilly CBC Complaints & Information Team be added (0800 328 40 61).
During the last year, the Local Authority Reviewing Officers have liaised with the CMO in respect of any issues identified whilst undertaking reviews. It is positive to note that the provider had acted on any concerns proactively and in a timely manner.
Customer Feedback
Unfortunately, only one individual responded to telephone contact from the CMO and feedback on the service was provided. Overall, the individual was happy with the service being provided by the care staff; however, stated that one or two tend to rush to leave quickly.
The customer advised that the care staff offer support 4 times daily and that “on the whole they are very good”.
Staff treat the individual with respect and dignity but do not necessarily have the time to talk. If carers are running late, then they ten not to always make contact and advise the customer of this.
ID badges and full uniform is worn by the care staff and the customer has never had to make a complaint about the service.
When asked if they were happy with the way the office staff deal with any issues, the customer advised “yes”.
When asked to rate the level of service out of 10, the customer rated it as 8 and stated “there is always room for improvement in everything”.
Due to the lack of contact, the CMO will continue to make contact with various contacts, and should any issues be raised, they will be relayed to the provider in a timely manner by the CMO.
Staff Feedback
As part of the monitoring process, two members of staff were contacted. When asked if there was sufficient travel time, both carers advised that in their opinion, for the majority of the time, they had sufficient time; however, if not, they would contact the office and request additional time and provide an explanation as to why. Both advised that they have sufficient time to provide the appropriate care and support and again, if they feel they the individual requires additional time, they will contact the office.
It was agreed that the rotas were acceptable both staff members felt supported by their supervisor.
One new carer advised that they had received a decent induction, appropriate shadowing and training. The second carer advised that she has worked for the provider for the last 11 years and often has new staff members shadowing her. The carer advised that should a new employee evidence that they would benefit for additional shadowing, this would be encouraged and fed back to the office for implementation.
Both employees advised that they have sufficient information at hand to provide the care and support required. However, should they have a new customer and information is limited, they would contact the office for additional information.
When asked if there was anything further, they wished to shared, one employee advised that a lot of staff do not remain working in the care sector due to finances and believes more money needs to be invested into the sector.
Corrective and Developmental Actions
Corrective
The Service Provider will notify the Social Worker (if one allocated) or via the IAA Team (if no Social Worker allocated) where an amendment to the ISC (Individual Service Contract) is required in any of the following circumstances: Where an increase in call length is required,
Where a decrease in call length is required (BG/Caerphilly Contract Appendix A)
The personal plan must be reviewed as and when required but at least every three months (RISCA Reg. 16). Timescale: Immediately and ongoing.
For copies of job descriptions to be retained on staff files. (RISCA Reg. 38)
Developmental actions
For the provider to share any positive feedback from customers of the service/family members/representatives or professionals with the Commissioning Team of the Local Authority.
For the provider to have a written record of the individuals preferred call times.
For the provider to ensure all shadowing documentation is scanned in a timely manner in readiness for future monitoring/inspection.
The service user guide was provided, and it is recommended that the document be dated and the contact details for Caerphilly CBC Complaints & Information Team be added (0800 328 40 61).
For Cera Care to look at terminology used within the DCP system.
Conclusion
The Contract Monitoring Officer would like to thank the Cera Care staff for their time and hospitality during the visit.
- Author: Caroline Roberts
- Designation: Contract Monitoring Officer
- Date: April 2023