Archived: Right at Home (Derby)

Updated 19 June 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 checked 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 inspection took place on 9,10 and 11 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that someone would be in the office to meet with us.

Inspection site visit activity started on 9 April 2018 and ended on 11 April 2018. It included telephone calls to people, their relatives and staff on 9 and 11 April 2018. We visited the office location on 10 April 2018 to see the registered manager and office staff, to review care records and policies and procedures and to visit people in their own homes.

The inspection was carried out by one inspector and two experts-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 asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what it does well and improvements they plan to make. We also viewed other information such as information reported to us, questionnaires which had been completed by a number of people using the service, their relatives and staff, and notifications. Notifications are specific events and incidents that occur within the service that the provider is required to notify us about.

During this inspection we spoke with the business owner who owned the franchise, the registered manager, the provider's quality compliance manager and five care staff. We visited three people in their own homes and observed how care was provided. We also spoke by telephone with one person and seven relatives. We reviewed five people's care plans and records to see if people were receiving the care they needed. We sampled four staff files including training and the recruitment process. We look at some of the provider's quality assurance and audit records to see how they monitored the quality of the service and other records related to the day-to-day running of the service.

Following the inspection, we asked the provider to send us information about key policies and procedures and they did this in a timely manner.

Updated 19 June 2018

This inspection took place on 9,10 and 11 April 2018. We gave short notice of the inspection because we needed to be sure the registered manager would be available to speak with us.

We last inspected the service on 24 November 2015. At this time the service was rated as 'Good' and was meeting the requirements of the regulations.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community in and around Derby. It provides a service to older people, people with a physical or learning disability and people living with dementia or mental health needs. Not everyone using Right At Home (Derby) receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, the service was providing care and support to 59 people.

The service has 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 the staff team from Right At Home (Derby). Staff members had a good understanding of the various types of abuse and knew to how to report any concerns.

Staff were skilled at ensuring people were safe. Potential risks people were exposed to had been identified and reviewed. Risks assessments included detailed information and guidance to support staff to follow measures to reduce the risk of harm.

People received care from a consistent team of staff who arrived on time. Staff confirmed that they usually had regular people that they visited and they were provided with the time they needed to meet people's needs.

People were protected from the risk of unsuitable staff because the provider followed safe recruitment procedures. People were supported by the appropriate number of staff as assessed in their care plans.

People were supported to take their medicines safely and staff followed procedures to reduce the risk of infection for people.

Staff were provided with the training they needed to have a full understanding, skills and knowledge to meet people's care and support needs. Staff were positive about the support they received from their managers. They were encouraged to be reflective in their practice and supported to develop and achieve their goals and aspirations.

Staff worked in partnership with other health professionals and agencies to ensure people's health and well-being was maintained.

People were supported to make decisions and choices about their care. Staff understood the principles of the Mental Capacity Act 2005 (MCA), sought consent before providing care and respected people's right to decline care and support.

People had positive relationships with staff who knew them well and used their shared interests to help people live interesting lives. People were fully involved in their care and, if necessary, were signposted to other agencies to support them to express their views.

Staff were kind and caring and were often quoted as 'going the extra mile'. Staff were committed to protecting people's right to dignity and privacy and treated people with respect. People were supported to maintain their independence as far as possible.

There was a strong emphasis on person centred care. People were supported to plan their care and support and they received a service that was based on their personal needs and wishes. The service had an innovative approach to supporting people to lead lives that were enriched and full. This included supporting people to pursue hobbies and interests that they had previously been unable to and enabling people to be part of their local and wider community.

The service used technology innovatively to enhance people's lives and well-being. Staff were flexible and responded positively to changes in people's needs.

People's concerns and complaints were listened to and responded to in order to improve the quality of care.

People, relatives and staff were able to express their opinions and views and were encouraged and supported to be involved in the development of the service. People were enabled to have links with the local community and staff worked in partnership with other agencies to improve people's lives.

The registered manager and the business owner demonstrated strong values and a desire to learn about and implement best practice throughout the service. Staff were highly motivated and proud of the service. The service had developed and sustained links with organisations that helped them develop best practice in the service. The registered manager and the provider used effective systems to continually monitor the quality of the service and had on-going plans for improving the service staff received.