RSM Care Services

This service is a domiciliary care agency and is based in the London Borough of Redbridge. The service provided personal care to adults and in their own homes. The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of our inspection, the service provided personal care to 19 people.

People’s experience of using this service

Since our last inspection on 1 May 2018, staff had completed essential training to perform their roles effectively. However, induction processes were not robust as some people raised concerns about new staff members understanding of people’s needs. We made a recommendation in this area.

Since our last inspection, improvements had been made on risk assessments. Care plans contained suitable and sufficient risk assessments to effectively manage risks and keep people safe.

Pre-employment checks had been carried out to ensure staff were suitable to support people. Some people raised concerns with timekeeping. However, arrangements were being put in place to ensure staff attended visits on time. Safeguarding procedures were in place to ensure people were safe.

Care plans were person centred and included people’s support needs. Care plans had been reviewed regularly to ensure they were accurate.

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 care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

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 7 June 2018). We identified four breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk assessments, need for consent, training and good governance.

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

This was a planned inspection based on the rating of the last inspection.

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.

The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service provided personal care to 44 people in their homes. This was the first inspection of the service since it registered with the CQC.

The service 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. This placed people at risk of not being supported in a safe way at all times.

People and relatives told us that medicines were given on time. However, there were discrepancies in people’s medicine records as records had not been kept of topical cream administration.

Pre-employment checks had not been carried out in full to ensure staff were suitable to provide care and support to people safely. We found the provider did not follow their recruitment policy in some instances, which detailed that two references should be requested before employing staff.

Staff had been trained to perform their roles by the provider’s in-house trainer. However, the qualification held by the trainer was not recent. Therefore, important updates on certain areas may not have been covered when training was delivered.

Some staff had not received Mental Capacity Act 2005 (MCA) training. Most staff we spoke to were unable to tell us what this was. Records showed that one person did not have capacity to make decisions and an assessment of their capacity using the MCA principles had not been carried out.

Effective quality assurance systems were not in place. The audits carried out by the service had not identified some of the shortfalls we found during the inspection.

Accurate and complete records had not been kept to ensure people received high quality care and support.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Pre-assessment forms had been completed in full to assess people’s needs and their background before they started using the service. Reviews were held regularly to identify people’s current preferences and support needs.

There were arrangements in place to ensure staff attended care visits on time. Staff told us they had time to provide person centred care and the service had enough staff to support people.

People were being cared for by staff who felt supported by the management team.

People had access to healthcare if needed.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

Staff, relatives and people were positive about the management team. People’s feedback was sought from surveys.

Complaints received had been investigated and relevant action had been taken. Staff were aware of how to manage complaints.

We identified four breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk management, training, need for consent and good governance. You can see what action we have asked the provider to take at the back of the full version of this report.