React Homecare Ltd

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

Medicines records and governance arrangements did not assure that medicines were managed safely. We have made a recommendation regarding medicines management.

Whilst the provider had safeguarding procedures in place safeguarding records were not always accurate or up to date to ensure oversite and governance.

The provider's quality systems were not sufficiently robust to identify the concerns we highlighted with medicines and safeguarding records. The provider was very responsive in taking actions to address the issues we found on inspection however we could not fully assess the impact of these actions until they were fully embedded.

People told us that they felt safe whilst receiving care and were complimentary about the standard of care and services they had received.

Risks to people’s health and well-being were clearly identified and care plans set out what support the person needed in the way they wanted their care to be provided.

People received consistent care from staff who knew them well and they were familiar with. One person told us, “Works like clockwork” and another said “I get used to the (staff) and when they come I don’t have to tell them what to do”.

Staff rotas were developed using an electronic call monitoring system. This ensured people received care as and when they needed it and reduced the risk of ‘missed calls’ occurring.

The providers policies and procedures had been revised in the light of the Covid-19 pandemic and staff had received relevant training, and had access to appropriate personal protective equipment (PPE) in accordance with government guidelines.

People who used the service, their relatives, friends and staff were unanimous in their praise for the registered manager. They told us that she was approachable, supportive and always responded effectively to solve problems and improve the service.

Rating at last inspection. The last rating for this service was good (published 13 April 2019).

Why we inspected

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of Safe and Well led only.

We reviewed the information we held about the service. No areas of concern were identified in other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified a breach of regulations in relation to governance and record keeping at this inspection. Please see the action we have told the provider to take at the end of this report.

Prompt action was taken by the registered manager after the inspection to mitigate risk and improve the quality of care in response to the concerns we found during our inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.

Clarity Homecare supports people in their own homes. At the time of our inspection 60 people were in receipt of the regulated activity ‘personal care’.

People’s experience of using this service:

Everyone told us they felt safe receiving care from the service. Staffing were deployed in suitable numbers, and staff had time to spend with people and were not rushed. Staff were recruited safely, and incident and accidents were analysed for patterns and trends. Risks to people were assessed safely. Medication needs were assessed, and medication was only given by staff who were trained to do so.

Decisions and consent to care lacked some information which we discussed at the time with the registered manager who agreed to address this. Staff had the correct skills to support people and their training was up to date and recorded in a training matrix. Staff were required to engage in supervision and had an annual appraisal. People were supported to eat and drink in accordance with their needs.

People were involved in their care plans. We received positive comments about the staff in relation to the support they provided. Everyone said staff were kind and caring. Staff were able to describe how they ensured people’s dignity was respected.

Some care plans contained a good level of detail with regards to people’s likes, dislikes and preferences for support. We saw however, that other care plans lacked some detail and basic information. We discussed this at the time with the registered manager who has since taken action to address this.

The registered manager was aware of their role and responsibility and had notified us of all incidents as required. The service was managed well, and the ethos and culture of the service was well implemented with the staff team that provided the care. Staff all spoke positively about the registered manager. Audits were in place which were effective in highlighting any areas for improvement.

Rating at last inspection:

This is the registered provider’s first inspection.

Why we inspected:

This was a planned comprehensive inspection.

It is CQC methodology to inspect newly registered providers within a 12-month timescale.

Follow up:

No concerns were raised within this inspection. We will therefore aim to re-inspect this service within 30 months. We will continue to monitor intelligence we receive about the service. If any concerning information is received, we may inspect sooner.

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