Reign Supreme Care Services Ltd

People’s experience of using this service and what we found

The service was well-led.

The registered manager had full oversight of the service and undertook audits, quality assurance and ensured staff were trained, monitored and recruited safely. Lessons were learned when things went wrong.

Information of how to reduce risks to people's safety were included in people's care plans. Care plans reflected people’s individual needs and reviewed with people and relatives to ensure they remained involved in their care.

People received person centred care according to their wishes and preferences. Care calls were consistently provided at the times they had been arranged for.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Feedback we received coupled with the processes and policies in place confirmed safe care was provided and people were protected against abuse, neglect and discrimination.

Medicines and infection control procedures were robust

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 14 May 2019)

Why we inspected

We undertook a focused inspection to review the key questions of safe and well-led and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Reign Supreme Care Services Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The office of the service is in central Leicester.

The service provides personal care to people living in their own homes who need support in living their lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People's experience of using this service:

Risk assessments were not comprehensively in place to protect people from risks to their health and welfare.

Staff recruitment checks were not fully in place to protect people from receiving personal care from unsuitable staff.

Relatives of people receiving a service told us they thought the service provided safe personal care.

Staff had been trained in safeguarding (protecting people from abuse). A staff member understood their responsibilities to safeguard people and to contact relevant agencies if needed.

The registered manager was aware that certain incidents, if they occurred, needed to be reported to us, as legally required.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, and further training was to be provided on people’s health conditions.

The staff member understood their responsibilities under the Mental Capacity Act 2005 (MCA) to allow, as much as possible, people to have effective choices about how they lived their lives. Staff were aware to ask people's consent when they provided personal care. Capacity assessments had not been in place to determine how best to support people who did not have capacity to decide aspects of their lifestyles.

Relatives told us that staff were caring, kind and friendly. They said they and their family members had been involved in making decisions about how and what personal care was needed to meet any identified needs.

Care plans were personalised with important information about people’s likes and dislikes and personal history. This helped to ensure that people’s needs were fully met.

Relatives were confident that any concerns they had would be properly followed up. They were satisfied with how the service was run. A staff member said they had been fully supported in their work by the registered manager.

Some audits to measure the quality of the service had been undertaken but others had not identified whether people were provided with a safe service.

Staff worked in partnership with relatives so that people got the support they required from other agencies.

Questionnaires had been supplied to people for their views of the service though not to staff, external professionals and relatives.

Rating at last inspection:

The service could not be rated at the last inspection as thaw service did not supply enough personal care to people. Our last report was published for the inspection of October 2018.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was the second inspection of the service. It was a comprehensive inspection. Following the last comprehensive inspection in 30 August 2017, where the service was rated as ‘requires Improvement’ for the first inspection, we asked the provider to complete an action plan to show what they would do to improve ensuring people’s safety. Because of these issues, breaches of regulations were found in Regulation 18, fit and proper persons employed. We received an action plan on 17 October 2017 which described how improvements would be made to systems to produce a quality service to people. On this inspection, the service had improved their systems so that the breach of Regulation 18 was met.

However, on this inspection, we were unable to award a rating for the service, as there was insufficient information available to us to fully assess how safe, effective, caring, responsive and well-led the service was with only having one person using the service.

The inspection took place on 19 October 2018. The inspection was announced because we wanted to make sure that the registered manager was available to conduct the inspection.

A registered manager was in post. This is a condition of the registration of the service. 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 and associated Regulations about how the service is run.

Risk assessments were not comprehensively in place to protect people from risks to their health and welfare.

Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff.

The relative of the person receiving a service told us they thought the service ensured safe personal care was provided by staff.

Staff had been trained in safeguarding (protecting people from abuse). A staff member understood some of their responsibilities in this area but was unaware of which agencies to contact if the provider had not acted appropriately.

Policies set out that when a safeguarding incident occurred management

needed to take appropriate action by referring to the relevant safeguarding agency. The registered manager was aware these incidents, if they occurred, needed to be reported to us, as legally required.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, though training on other relevant issues had not yet been provided.

The staff member understood their responsibilities under the Mental Capacity Act 2005 (MCA) to allow, as much as possible, people to have effective choices about how they lived their lives. Staff were aware to ask people's consent when they provided personal care. A capacity assessment was in place to determine whether any restrictions on people’s choice was needed, in the person's best interests.

The relative told us that staff were friendly, kind, positive and caring. They said they and their family member had been involved in making decisions about how and what personal care was needed to meet any identified

needs.

Care plans were not fully personalised as it did not include important information about the person’s likes and dislikes and personal history. This did not help to ensure that the person’s needs were fully met.

The relative was confident that any concerns they had would be properly followed up. They were satisfied with how the service was run. A staff member said they had been fully supported in their work by the registered manager.

Audits on the quality of the service had been undertaken but comprehensive audits on all important aspects had not been undertaken to check that the service was meeting people's needs and to ensure people were provided with a quality service.

Staff worked in partnership with other agencies. Information was shared appropriately so that people got the support they required from other agencies and staff followed any professional guidance provided.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed.

Reign Supreme Care Services Limited is registered to provide personal care and support for people living within their own homes. At the time of our inspection there were three people using the service, of which two people had been using the service for a period of two weeks or less. People’s care was provided by the registered manager and two members of care staff. People's packages of care varied dependent upon their needs.

This was the first inspection of the service since it was registered 6 June 2016.

Reign Supreme Care Services Limited had a registered manager. 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’s safety and welfare was compromised as staff recruitment practices were not robust. Pre-employment checks were not consistently carried out. This meant staff were providing care and support to people, before their suitability had been confirmed.

People’s safety and welfare was risk assessed and guidelines to reduce potential risk to people were documented within their records. This included instructions and guidance as to the use of equipment to reduce the likelihood of risk and potential harm.

Staff underwent a period of induction, which included their being introduced to people whose care and support they would provide. This meant staff had an understanding of their role and responsibilities in providing care and were able to deliver care as detailed within people’s care plans. Staff were not involved in supporting people with their medicines, any support required was provided by family members.

Staff understood the importance of seeking people’s consent prior to providing care and support. Staff liaised with health care professionals where necessary and kept in contact with people’s family members where they had concerns about people’s health. People received support with the preparation of meals where needed to ensure people’s nutritional needs were met.

People’s records, including their care plans had been developed with the involvement of themselves or their family members and provided information for staff about the person. A person spoke positively about the attitude and care of staff and received care.

People’s views about the service were sought by the registered manager and staff told us they had confidence in the management of the service. The registered manager was not fully aware of the topics of training covered as part of staff induction. The registered manager had identified within the PIR planned improvements for the next 12 months as part of the services expansion.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.