Background to this inspection
Updated
28 September 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was completed by one inspector and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 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 notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 21 June 2019 and ended on 03July 2019. We visited the office location on 28 June 2019.
What we did;
Before inspection:
¿ Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public and local authorities. We also checked records held by Companies House. 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.
During inspection:
¿ We spoke with two people who used the service and eight relatives.
¿ We spoke with the seven care staff members, the recruitment and compliance officer, the registered manager and the operational manager. We looked at aspects of four people’s care records and other records that related to people’s care such as medication, audits and other documentation about the management of the service and three staff recruitment files.
After inspection:
¿ We contacted external healthcare professionals. We spoke with a representative from the hospice and had written feedback from a specialist nurse for complex discharges and a CCG contracts manager.
Updated
28 September 2019
About the service: R&L Healthcare is a domiciliary care service. At the time of the inspection 51 younger and older people who may have a physical, mental or sensory impairment, a learning disability or dementia were receiving personal care. R&L Healthcare’s main service was caring for people who were returning home from a hospice or a hospital for end of life care and support.
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:
People told us they felt safe and well supported. Staff had a good understanding of how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people had been identified through assessments and people had been involved with decisions in how to reduce the risk of harm to them. There were enough staff on shifts to keep people safe and meet their needs in a timely way. People’s medicines were managed in a safe way. Safe practice was carried out to reduce the risk of infection. Where incidents had happened, lessons had been learnt and shared with the staff group.
People’s care was assessed and reviewed with the person involved throughout. Where people had support with their meals they were given food they enjoyed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff worked closely with external healthcare professionals and followed their guidance and advice about how to support people following best practice.
People were cared for by staff and management team who were passionate about supporting people to have a comfortable and dignified death in their own home. Staff demonstrated empathy and understanding for the people and relatives who were under their care. People were supported by staff who were warm and considerate towards them, who people considered friends. The management team and staff consistently went the extra mile. People and their relatives felt involved and supported in decision making. People's privacy was respected, and their dignity maintained throughout.
The delivery of care was in line with people’s preferences. Any changes in people’s care was communicated clearly and promptly to the staff team. Staff were trained to support people with their end of life care. People had access to information about how to raise a complaint.
The registered manager and management team were open, approachable and effective. They focussed on providing person centred care. They engaged well with other organisations and had developed strong and positive working relationships. The checks the registered manager made to ensure the service was meeting people’s needs focused upon people’s views and experiences. They promoted strong community links to ensure people could access the support they needed.
Why we inspected: This service was registered with us on 18/06/2018 and this is the first inspection. This was a planned 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.