Archived: Roche Caring Solutions

Updated 25 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This announced inspection site visit activity started on 19 September 2018 and ended on 2 October 2018. It included visits to the location and telephone calls to people who used the service, relatives and staff. We gave short notice of the inspection as the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. The inspection was carried out by one inspector, a pharmacist specialist advisor and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed all the information we held about the service including statutory notifications. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. We contacted relevant agencies such as the local authority commissioners, safeguarding and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

On this occasion we did not ask the provider to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection, we spoke with the registered manager, the senior manager for domiciliary care, the compliance manager and six staff. We spoke with seven people who used the service and ten relatives.

We spent time looking at documents and records that related to people’s care and the management of the service. We looked at six people’s care records and five people’s medicines records.

Updated 25 October 2018

This announced inspection took place on 19 September 2018. On 20 September and 2 October, we made telephone calls to people who used the service, relatives and staff.

At the last inspection in October 2017 we rated the service as Requires improvement. At that inspection we found the provider was in breach of Regulation 12, Safe care and treatment and Regulation 17, Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found the registered person did not have systems for the proper and safe management of medicines and systems in place to manage, monitor and improve the quality of the service provided were not always effective.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe and Well-led to at least good. During this inspection we found improvements had been made. Systems for managing medicines safely were now effective. Records of people’s medicines were accurate and well maintained. Also, the provider had introduced systems that were effective in assessing and monitoring the quality of the service provided. Staff and people were confident that issues would be addressed and any concerns they had would be listened to and acted upon.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. There were 66 people using the service at the time of the inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe with staff and the care they were provided with. They said they received a good standard of care. Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns. Care plans contained risk assessments which gave instructions to staff as to how to mitigate risks; these enabled and empowered people to live as independent a life as possible safely.

There were enough staff to support people safely. Staff understood their role and responsibilities for maintaining good standards of cleanliness and hygiene. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

Training records showed staff had completed a range of training and staff spoke highly of the training they received. Staff told us they received support, supervision and appraisal to help them understand how to deliver good care and records we looked at confirmed this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. The registered manager and staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005). Staff understood their responsibilities to seek people's consent prior to care and support being provided.

People's health and well-being was monitored by staff and they were supported to access health professionals when they needed to. Where needed, people who used the service received support from staff to ensure their nutritional needs were met. Staff were trained to respond to emergencies and said they felt confident to do so. There were systems in place to make sure there was learning from any accidents and incidents.

People received care from staff that were friendly, kind and caring. People told us they were treated very well. Staff showed a good knowledge of the people they supported and understood how to maintain people’s privacy and dignity.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist staff to provide care and support in an individualised manner. Peoples care and support needs were reviewed regularly

People, staff and relatives spoke positively about the management team who were visible and approachable, receptive to ideas and committed to providing a high standard of care.