Background to this inspection
Updated
12 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager who had not yet registered with the Care Quality Commission. This meant the provider was legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the nominated individual, manager, care co-ordinator and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate the evidence found. We looked at training data and quality assurance records. We spoke again with the manager, nominated individual and care co-ordinator.
Updated
12 June 2021
About the service
Right Care (NW) Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger and older adults with various needs including, people with physical disabilities, sensory impairments, mental health conditions, and dementia. At the time of this inspection 25 people were using the service. Not everyone who used the service received personal care. The Care Quality Commission (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
The current manager had not yet registered with CQC but had started the application process. Following the last inspection, the provider recruited the new manager to focus on improvements which needed to be made relating to governance and recruitment; we found these had been implemented. However, some improvements were still needed in relation to the development of risk assessments, auditing and call schedules. We have made a recommendation the provider continues to develop risk assessments for all aspects of people’s care.
People’s care and daily records were recorded on an electronic recording system. Medication records were built into people’s daily records and it was clear when people had received their medicines. However, electronic medication administration records (EMAR’s) had not been built into the system; this was addressed by the provider who contacted the developer of the system to request EMAR’s be implemented. The providers new recording system enabled continued oversight from the management team and helped the provider to respond to things that go wrong, in a timely manner. We have made a recommendation the provider continues to develop their electronic recording system, so it incorporates pharmacy sent EMAR’s.
People felt well cared for by carers and knew who to contact if they had any concerns. The improved organisation and communication had a positive impact on people’s care, and this was evident through their feedback. The provider had robust quality assurance systems in place; however, this was sometimes evidenced in daily audits, rather than an overarching audit record. We have made a recommendation the provider develops audit records, to include a record that evidences the daily quality assurance that is undertaken.
Staff had received regular supervision and support. Important training, such as medication, safeguarding and moving and handling, had been carried out regularly. Staff felt well supported by the management team; however, feedback was mixed on the scheduling of call times and how this had impacted on travel times between calls. We discussed this with the manager following the inspection and they advised this would be reviewed to ensure staff had enough time to travel between calls. We have made a recommendation the provider maintains a realistic amount of time is allocated to care staff for travel.
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 requires improvement (published 21 September 2020). 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 regulations.
Why we inspected
We carried out an announced inspection of this service on 21 August 2020. Breaches of legal requirements was/ were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance and fit and proper persons employed.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-Led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Right Care (NW) Ltd 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.