Background to this inspection
Updated
8 January 2020
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
This 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 homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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.
Inspection activity started on 19 November 2019 and ended on 21 November 2019. This included phone calls to people and requesting feedback from their relatives. We visited the office location on 19 November 2019.
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. We used the information the provider sent us in the provider information return. 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 four people who used the service and received feedback from two relatives about their experience of the care provided. We spoke with six staff including the nominated individual (The nominated individual is responsible for supervising the management of the service on behalf of the provider), registered manager, quality and compliance manager, care manager, senior support worker and a care worker.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two 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 evidence found. We looked at training data and quality assurance records.
Updated
8 January 2020
About the service
Right at Home Worthing & Shoreham District is a domiciliary care agency (DCA) and it provides personal care to people living in their own homes. It provides a service to support people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with long-term health related conditions. The DCA provides 'live-in' support for people who want care staff available throughout the day and night. At the time of this inspection the service provided personal care to 18 people.
'Right at Home' is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's products in a particular area using the company's name.
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 said they felt safe and were protected from harm. A person said, "I feel very safe. They [staff] have got to know me, what my care needs are and do that safely.”
Staff had a good understanding of what safeguarding meant and the procedures for reporting any issues of harm to people. All the staff we spoke with were confident any concerns they raised would be followed up appropriately by the registered manager.
Staffing levels were specific to individuals. A person said, “I have a superb service, because of the calibre of staff. I mostly have the same staff and have had for 3 years. They are never late, and I have never had a missed call. My main carer, who I have five days a week, is now more of a friend than a carer. I like my calls early, at 7am. This gives me the rest of the day for myself and this time has never ever been a problem.” The staff recruitment procedures ensured appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.
Medicines were managed safely by trained staff. Effective practices were in place to protect people from infection.
Staff received supervision and appraisals to support them in their role and identify any learning needs and opportunities for professional development. Senior staff carried out spot checks on staff to monitor the quality of the service provided and to seek the views of the people who were supported.
Staff supported people to have enough to eat and drink and to make choices about what they ate and drank. A person said, “They make my meals for me, we plan this together to make sure certain foods are taken out the freezer in time. They are always thinking ahead to make sure I have enough stock in the cupboards and fridge so I don’t go hungry.”
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. People received appropriate healthcare support as and when needed and staff knew what to do to summon assistance.
People were supported by kind and caring staff who knew them well. People spoke highly of the staff who looked after them and said they were treated with dignity and respect. A person said, “The staff really care for my modesty. And treat me with respect. We have a laugh and a joke. They always encourage me to do what I can do. I can wash certain parts of my own body, and they allow me to do this, they respect this.”
People were involved in all aspects of their care and were supported to express their views. Complaints were investigated and managed appropriately in line with the provider's policy.
The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them. The service worked in partnership with other agencies to ensure quality of care across all levels. People, relatives and staff were encouraged to provide feedback about the service. There was a culture of openness and transparency. Staff were positive about the management and leadership of the service.
The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.
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 5 December 2018).
Why we inspected
This was a planned inspection based on the previous rating.
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.