Reedsfield Care Ltd

Reedsfield Care Ltd is a domiciliary care service providing personal care to people living in their own homes. The service provides support to people living with dementia and those with enduring healthcare needs. At the time of our inspection, there were 70 people receiving a service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People were cared for by a sufficient number of staff who were given enough time to spend with people and travel time between calls, which helped them arrive on time. Staff were given sufficient guidance around people; their care needs and potential risks. This enabled them to help ensure people remained safe in their own home whilst receiving appropriate, person-centred care.

People were cared for by staff who received appropriate training. This helped ensure staff were confident and competent in their role. Staff were able to describe what they would do should they suspect a person was the subject of abuse. They were also able to tell us how they treated people with dignity, encouraged their independence and enabled people to give their consent and make their own decisions in relation to their care.

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. Staff empowered people to make own decisions about their care and support and consent was sought in line with legislation.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture (RSRCRC), as it is registered as a specialist service for this population group.

People were happy with the care they received from Reedsfield Care Ltd. They were given regular opportunity to feedback their views on the service and they were provided with clear information on how to make a complaint should the need arise.

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 good (published 14 July 2021).

Why we inspected

We received concerns in relation to staff not fulfilling their contracted support hours. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 remains good, based on the findings of this inspection.

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

Reedsfield Care Ltd is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection the service was supporting 35 people with a variety of health needs and some people living with dementia.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People told us they felt safe with staff. Staff knew how to recognise a safeguarding concern and how they needed to report any concerns.

Risks to people were assessed and monitored. Peoples care plans were detailed and included information for staff on how to care for people. Infection prevention and control procedures were in place and staff were supported to follow these.

There were enough staff to care for people and people were usually cared for by the same care workers. People were supported with their medicines by staff who have received appropriate training.

Assessments were carried out before the agency provided care to people. Details of people’s needs were recorded into the plan of care so staff knew how to support people. People were supported with meals and were offered a variety of choice. Where people required a special diet, this was documented.

People told us staff were kind and caring. Care plans and daily records were written in a kind manner and the management team demonstrated a caring attitude. People and their families were involved in care plan reviews and the service actively sought feedback from people about the care they received.

The service carried out a variety of audits to monitor the service and took action to make improvements where needed. People told us that the service was well run and they knew how to contact the registered manager if they needed too.

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.

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

Rating at last inspection and update

The last rating for this service was inspected but not rated (published 16 September 2020) and there was a breach in regulation from the previous comprehensive inspection (published 22 May 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Reedsfield Care Limited is a domiciliary care service that was providing personal and nursing care to 25 people within their own homes. The service supported older people, people with physical disabilities, learning disabilities and mental health conditions.

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

People told us they felt safe and well treated by staff. People told us they received their medications on time and trusted staff to manage them when needed. Some people chose to manage their own medicines or had assistance from family.

The provider had made improvements with how they monitored and recorded staff call times. The provider had a system in place to be able to show when staff started and ended calls with people. Although this was an improvement it also highlighted that staff were often late to calls. We found this had very little impact with people and did not put anyone at risk of harm as four of the five people we spoke to had been happy with call times. One person did tell us they would like more consistent calls times.

The provider had made improvements around their risk management. People had detailed risk assessments in place within their care plans which were reflected in their pre-assessments. People had their needs fully assessed including any environmental risk prior to any care packages starting.

The provider had made improvements with the management and auditing around people’s medicines. We found that the provider had a robust audit process in place to check for any errors. The provider had moved back to a paper only medicine administration record (MAR) which meant there had not been any duplicate recording issues.

The registered manager had made improvements with regards to the monitoring and auditing of the service. They had introduced regular medicines audits alongside regular updates around governance to show that issues had been reviewed and actioned. As the registered manager had paused most of the monitoring during Covid-19 they stated this would now be resumed. Improvements seen would need further time to embed across the service to be more consistent.

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 (report published 21 May 2019).

Why we inspected

We undertook a targeted inspection to follow up on a warning notice we issued the provider following the previous inspection. This report only covers findings in relation to care which people received, safe care and treatment, medicines, staffing, safeguarding people from abuse and management of the service.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-Led sections of this full report. Although the provider has made improvements and met the legal requirement to comply with the warning notice they still need further time to embed the changes across the service more consistently. We will check for further improvement at the next comprehensive inspection.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question

The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Reedsfield Care Limited is a domiciliary care service that was providing personal and nursing care to 26 people within their own homes. The service supported older people, people with physical disabilities, learning disabilities and mental health conditions.

People’s experience of using this service:

People told us they felt safe but we found continued shortfalls in relation to medicines, risks and care planning. Records relating to medicines were not accurate and where risks were identified the plans to keep people safe were not robust. Care plans were inconsistent and we found instances where important information about people’s needs and preferences was lacking. We also found a lack of information about people’s food preferences.

The provider had not always completed assessments in a timely manner which meant important information about needs and risks had not been gathered and planned for. People told us they were not always sure what time to expect staff and we found instances where the provider was not following their policy regarding call times. People had consented to their care but we found one instance where records relating to this needed improving. Records were not always up to date or complete. The provider's auditing and governance processes were not proactively identifying and addressing the issues that we found. The provider had not always notified CQC of incidents they were required by law to.

People told us that the staff who supported them were caring and we heard examples of people being supported to develop skills and independence. People told us that staff were respectful when providing care in their homes and were competent in their roles. Staff had received training and regular checks and supervision to assess their practice. There were regular staff meetings and staff told us important information was passed to them each day through handovers. Records showed regular work with other organisations and referrals to healthcare professionals when required.

Rating at last inspection: Requires Improvement (Published 18 May 2018).

Why we inspected: This was a planned comprehensive inspection based on the previous rating.

Enforcement: Action we told provider to take (refer to end of full report)

Follow up: We will request an action plan from the provider and continue to monitor the service. We will return to the service to inspect it again in line with our policy.

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

Reedsfield Care Ltd is a domiciliary care agency. They provide hourly support to people within their own homes. At the time of our inspection there were 15 people receiving personal care. The service provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people with physical disabilities and people with long term medical conditions.

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.

There was not always robust governance at the service. We identified issues that the provider had identified through audits but these had not been addressed. Records relating to people’s medicines contained gaps and despite these having been identified in audits, they had not been addressed by the time of our visit. We also found that some information in people’s care records lacked detail and that negative feedback about time keeping identified in surveys had not been addressed.

We also found some records relating to individual risks lacked guidance for staff. Shortfalls in medicines records meant that medicines management was not always safe. You can see what action we told the provider to take at the back of the full version of the report.

People were supported by staff that had the training to carry out their roles. Staff told us that they felt supported by management and had regular supervision meetings. Staff were trained in best practice with regards to infection control and were knowledgeable in this area. Staff met regularly to discuss care delivery and the registered manager had an open door policy. We did receive some negative feedback about staff punctuality. We made a recommendation about staff deployment.

Risks to people were assessed and managed safely. Where people had suffered incidents, such as falls, staff took appropriate action and the provider kept a record of these and analysed them. Staff understood their roles in safeguarding people from abuse and were knowledgeable about people’s needs. People were provided care in a way that promoted their independence and they received person-centred care. However, we did find instances where records lacked detail. We made a recommendation about care planning.

People were supported by kind and caring staff that they got along well with. Staff were respectful when entering people’s homes and provided care in a way that preserved people’s dignity and was respectful of their privacy. People were given choices by staff and involved in their care. Staff sought consent from people and this was documented. We did find one instance where documentation was not up to date for a person who could not consent. We made a recommendation about consent records.

People received a thorough assessment before they received a service and people’s care was regularly reviewed. Staff met people’s nutritional needs and supported people to access healthcare professionals where appropriate. People were regularly asked for feedback on the care that they received there was a clear complaints policy in place. Where people had raised a complaint, the provider had investigated these appropriately and identified actions to address concerns.

The provider carried out checks on all new staff to ensure they were suitable for their roles. There was a vision for the service and the provider had developed links with the local community. There was a plan to ensure that people’s care could continue in the event of an emergency.