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What our customers can expect 

The Care Worker Agency provides customers with the quality of care that we would expect for our own families. For this reason the The Care Worker Agency aims to deliver a consistent high level of care service.

Policy

It is the aim of The Care Worker Agency to ensure that all care services delivered by the company are managed and monitored closely; in the interests of maintaining high quality and safety for our customers.

For this reason responsible senior staff within the organisation will be identified and appointed to manage the care activities; to ensure that all care is delivered safely and effectively and that it is caring and reactive to the customers individual needs. It is the aim of The Care Worker Agency to ensure that these activities are well-led at all times.

It is the responsibility of the Directors of the company to oversee all activities at The Care Worker Agency, to act as the nominated individual/Registered Manager and to ensure that there are sufficient trained and skilled staff available to meet the needs of the customers at all times.

As the responsibility of the service ultimately lies with the Directors; it is their responsibility to put systems in place to ensure that the service is safe, effective, reactive, caring and well-led, as per CQC requirements. Responsibility for aspects of the service can be delegated to employees, but it remains the Director's responsibility to check that these activities are being completed as required in line with all pertinent legislation; and to take swift action when this is not the case.

Procedure

The Company Directors must create a structured staffing system to ensure that there are always sufficient numbers of trained and skilled staff capable of meeting the customers needs at all times. This includes the need for an on-call/out of office hours service to support the care staff working in the community and also to support the customers that might need additional support and advice from a more senior member of the team.

Staff must all complete a robust recruitment, induction and training programme, and must be supported with ongoing training and development opportunities; including access to regular staff meetings, job shadowing, supervision/one to one feedback session and appraisals. It is the stance of the company that all of these activities play a role in supporting the delivery of high quality care and must be prioritized.

The Care Worker Agency Team

Managing Director - Fay Townsend-Jackson Registered Manager - Stacy Dunne

Area Supervisor/Senior Care Staff/Care Coordinator 

Care  & Support Staff

Appointing appropriate staff

The Directors will recruit for suitably qualified care staff prior to the commencement of care services being opened, and will follow the policy on recruitment, induction and training for staff.

The process of recruitment will be noted as a continual cycle, as a stream of staff will be needed to meet possible customer demands; and this will facilitate the service being reactive. It is however the companies aim to retain staffing levels inside industry norms and to be a supportive employer in terms of work/life balance and work flexibility.

At the point of reaching 500 hours of care delivery a Coordinator will be appointed to support the Registered Manager; to allocate work safely and appropriately and to support the care workforce team. At the point of reaching 1000 hours a second Coordinator will be appointed and this will continue etc., depending on the levels of customer uptake and hours of delivery.

An Area Supervisor/Senior Carer will be appointed to support quality assurance and staff training issues. The point at which this role is required will be at the discretion of the Registered Manager; but will be identified at the point of balancing customer need and maintaining quality.

When one particular area of care service reaches 800 hours, a Care Manager will be appointed to support the Registered Manager in overseeing safe care delivery and to maintain supportive relationships with other relevant professionals.

Care planning and assessment 

1. A qualified member of staff, usually a supervisor, must visit customers prior to care commencing to:

Find out about their wishes and preferences (this may include their wishes in

the event of their death);

Assess their needs for care and support;

Assess and manage any risks to health and safety;

Produce a care and support plan;

Explain to customers what they can expect from The Care Worker Agency,

the Customer Guide, the Care and Support Plan folder and the Compliments,

Concerns and Complaints Procedure;

Arrange the dates for care and support to start and an introductory meeting between the care worker(s) and the customer.

2. When arranging the visit, ask the customer if they would like anyone else to be involved with planning their care and support.

3. At the visit explain the ethos of The Care Worker Agency and what you will be discussing. Put the customer at their ease. Explain The Care Worker Agency policy with regard to confidentiality.

4. (For guidance on completing the assessment and care and support plan see the 'Customer Support Plan Guidance'). Complete all of section 1 and the first page of the generic care and support plan (section 2). This identifies which types of activity the customer would like support with.

5. Carry out the specific assessments for each type of activity (section 3) with the customer. Delete any activities that do not apply to keep the plan as concise as possible. For each activity there is a separate risk assessment. Explain any risks to the customer and the options for reducing the risk. Include details of the agreed actions to mitigate any risks within each of the risk assessments. Complete the general environmental and COSHH risk assessment (section 5). Do not commence the care and support until you have assessed that it is safe to do so.

6. Using the activity specific risk assessments, produce the generic plan of daily care and support with the customer and/or their representative.

7. If it feels appropriate, ask the customer if they would like you to record information about their wishes for the end of their lives.

8. At the end of your visit explain to the customer that:

Any changes in the agreed care plan can only be made via the office and not directly with care workers for their own safety;

The care worker will write down what care and support they gave during each visit in the 'visit record' and or on the Nursebuddy online system;

The care worker will always wear the The Care Worker Agency uniform and will have an identity badge;

There is a 'Customer Information Guide' in the customer folder (go through this and explain what they can do if they have a concern or a complaint); The customer can request a review of their care plan at any time.

9. When you return to the office type up the Customer Care and Support Plan. Place one copy on the customer's file in the The Care Worker Agency office and arrange for the customer to sign the other copy to indicate their consent to the care and support. Place this second copy in the Customer and Support Plan folder at the customer's home.

10. There may be circumstances where the customer lacks the capacity to provide written consent, e.g. due to a physical or mental impairment. Depending upon the circumstances, their attorney may consent on their behalf if they have one (refer to policy on Mental Capacity and Customer Support Plan Guidance). In some cases it may not be possible to obtain written consent.

11. Provide the care worker with a copy of the care plan or a written brief about the care and support prior to their first visit to the customer. In exceptional circumstances this may not be possible. In these cases give the care worker a verbal briefing and refer them to a written copy of the care and support plan as soon as is practicable.

12. Care workers should always follow the care plan. On each visit the care worker must refer to the care plan and visit record prior to delivering care to ensure they undertake the tasks as required and that there have been no changes since their last visit. Where changes to the care and support plan are needed, the care worker must contact the office for a review.

13. At the end of each visit the care worker must clearly record the date, time and the care and support that was provided on the visit record. If the care given was different from the care plan, then the care worker should explain why. The care worker must then sign the record and report to the office.

14. In the event of the care worker identifying problems or having concerns regarding a customer then this must be accurately recorded on the visit record, reported to the care manager or person on call. The care worker must detail on the visit record who they reported the matter to and what advice was given regarding actions to be taken.

15. Where appropriate the care manager must ensure people are informed of these concerns i.e. next of kin, health professionals, social services etc. The customers' contact records must clearly document the nature of the concerns, when they were reported and by whom, who was informed and what information was shared, any advice given and the outcomes.

16. If the care and support plan includes handling the customer's money, a financial transaction sheet will form part of the care plan. Care workers must fully complete these each and every time they handle customer's money (see policy on 'handling money').

17. If the care and support plan includes assistance with medication, the care worker must follow the Medication Administration policy and procedure and complete the medication records.

18. The care worker must ask each customer to sign their timesheet (if they are able) to confirm the date, time and duration of the visit. Care workers should return these timesheets to the office within 48 hours of the end of the relevant week.

19. On a monthly basis either supervisors will collect the completed visit reports (and financial transaction/MAR sheets if appropriate) and put them on the customer's file in the office or the care worker will bring them to the office. Any contact between the customer and the office will be logged on the 'contact sheet' which is part of the customer's file.

20. The supervisor will review the visit records, timesheets, MARS and financial

transaction sheets to make sure that the care and support plan is being followed.

Reviewing the care and support plan

When to carry out a review

21. Review each customer's care and support plans at least six monthly. Carry our reviews more frequently in response to;

A request from a customer or their representative;

A change of circumstances e.g. declining or improving health, changing physical condition, admission or discharge from hospital;

Information from the care worker that suggests a review visit is necessary;

A complaint or information on the annual survey that suggests the customer is

dissatisfied with their service.

How to carry out reviews

22. In line with our participation strategy, support customers to have their say about how

the service is provided by:

Arranging with the customer a time for the review at least a week in advance; Asking the customer who else they would like to invite and arranging a mutually convenient time for the review to take place so that their representative(s) can

attend;

• Finding out if the customer needs any special support to help them participate in the review e.g. signer, interpreter etc.

What to do at the review

23. Use the template appendix 1. There are two parts to the review:

Review of the care and support plan and get customer feedback on their experience of the service.

24. During the visit customers may choose to give feedback about the quality of the service as you discuss their care needs and support. Be flexible so that the customer is able to freely express their views.

Review of care and support plan

25. Before the visit consider whether information gathered from the visit records or MAR sheets or financial transaction records indicate areas to include at the review meeting.

26. At the visit go through each section of the care plan and find out whether there are any changes to the information that you hold (see page 2 above or refer to 'Customer care and support plan' guidance).

27. Record any changes that are needed to the care plans or risk assessments, on the review form at appendix 1. Ask the customer or their representative to sign the review form to indicate that they agree with the assessments and proposed changes to the generic and service specific care plans.

28. Confirm to the customer that The Care Worker Agency will only provide the support that has been agreed with the customer and/or their representative in the care plan.  

29.Inform care workers about any care plan changes before their next visit to the customer.

Customer feedback on the quality of service

30. Ask the customer for feedback about the quality of the service that they have received. The review form contains a number of prompts to assess quality. Ask open ended questions where possible to encourage the customer to tell you about their experience of the service and about whether they have found it satisfactory. Use a conversational style rather than a tick box approach because this is more likely to put the customer at their ease.

31. The review template includes a scale of responses (yes, mostly, sometimes, rarely).

You do not have to use these categories and could simply note customers' comments instead. Categorising responses into a standardised scale will, however, help you to make comparisons in the performance of the business over time.

Observation

32. Part of the review of the quality of the service may include direct observation of the care. This will tell you how a task is being performed and can be compared against the visit records. Carefully record observations and reference these in the care worker files.

33. Examples of observations may include:

• Spot checking arrival or departure times of the care worker;

• Accompanying the care worker to see how the care worker relates to the

customer;

• Assessing the skills of care workers when carrying out care practice such as

moving and handling.

Record improvement actions where appropriate and set a review date to make sure that these actions are followed through.

34. After the review

Issue new electronic copies of any revised or new sections of the care plan information and place these in the white 'Care and Support Plan' folder at the customer's home. Send a copy of the standard letter (see appendix 2) to the customer.

Quality monitoring

Managers must audit a sample of customer reviews against this guidance and the guidance on care and support plans on a monthly basis. These audits form part of the quality management systems and must be stored in a separate file marked monthly audits. The Managing Director will check this data as part of their overall quarterly quality assurance audit; and will consider this data in context with other relevant issues, such as accident incidents, complaints, grievances and staff disciplinary issues.