Retain Healthcare Ltd, Chippenham

Updated 30 December 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

This inspection was carried out by an inspector and an 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. Day to day management responsibilities were carried out by a branch manager who was not registered. We have referred to them as the ‘manager’ in the report.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ 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 9 November 2021 and ended on 2 December 2021. We visited the office location on 12 November 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received 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 three people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff, the branch manager, programme manager, a director of the company and the registered manager. The registered manager is also the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed seven people’s care records and medication records, risk assessments, incident reports, staff meeting minutes and various records relating to the management of the service. This included various policies and procedures. We also looked at four staff files in relation to recruitment.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at incident and accident records and meeting records We contacted local commissioners for their feedback about the service.

Updated 30 December 2021

About the service

Retain Healthcare Ltd, Chippenham is a domiciliary care service providing care and support to people living in and around Chippenham. 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

Risks to people’s safety had been identified, assessed and management plans put into place to mitigate risks. Changes had been made to risk management following a serious incident which the provider had reflected on and implemented improvements.

Incidents and accidents had not always been recorded on the providers incident system which meant action taken in response was not recorded. Whilst the provider could demonstrate staff had reflected on incidents and identified improvements, this did not evidence the providers response and action taken. We have made a recommendation about reviewing incident recording.

People had their medicines as prescribed; however, for one person staff had not carried out a safety check with the prescriber. The provider took action during the inspection to carry out this check and make sure staff were administering medicines safely. Staff had been provided with training on medicines management and had their competence to administer medicines checked by senior staff.

People and their relatives told us the service was safe. Staff had been trained on safeguarding and understood how to report any concern they had. Staff were assured the provider would take appropriate action in response to any concern raised.

People had received their visits and told us the staff were reliable. Whilst the provider was actively recruiting more staff there were enough staff available to meet people’s needs. All staff had been recruited safely.

Staff were being tested regularly for COVID-19. They had plenty of personal protective equipment and received regular updates on how to work safely during COVID-19. The provider had identified COVID-19 champions who made sure up to date government guidance was being followed by all staff.

People, relatives and staff told us the service was well-led. There was a registered manager in post and a senior team who provided additional management cover. People and relatives were able to share feedback and make suggestions for improvements. Staff had regular staff meetings and felt able to share any views or concerns. People and relatives were happy with the care they received and felt staff were trained and professional.

Quality monitoring systems were in place and identified areas for improvement. There had been a recent serious incident which had been investigated. The provider had reviewed their systems and processes to make improvement to how they carried out some quality and safety checks. People told us some improvement was needed to communication, so they knew when changes were made to their regular staff. The provider had identified improvements they could make to improve outcomes for people for that area such as providing people with a staff rota.

The service worked in partnership with a range of professionals and met regularly with representatives from the local authority. Staff were providing support to people being discharged from hospital and working with professionals to help people regain independence. People and relatives told us staff were reliable and they would recommend the service.

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 27 September 2019).

Why we inspected

We received concerns in relation to risk and incident management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The provider had taken action to mitigate risks by reviewing systems in place for risk management and monitoring and assessing quality and safety. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Retain Healthcare Ltd, Chippenham 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.