Rani Care C.I.C.

Rani Care is a domiciliary service providing personal care to 5 people aged under 65 and over at the time of the inspection.

People's experience of using this service and what we found

The provider had made improvements in relation to management of medicines. Systems were in place to ensure medicines were administered safely. Staff were provided with medicines training to ensure their practice was safe.

Individual risk assessments were in place and detailed people's care and support needs. Environmental risk assessments had been carried out to ensure people and staff were safe within the person’s home. Staff were provided with sufficient training to manage risks to people’s health and safety.

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 19 June 2019) and there was a breach of regulation 12 (Safe care and treatment). 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 enough improvement had been made and the provider was no longer in breach of regulation 12.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns identified at the previous inspection; in respect of medicines and risk assessments. A decision was made for us to inspect and examine those risks.

We undertook this targeted inspection to check whether the requirement notices we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rani Care C.I.C 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 reinspection programme. If we receive any concerning information we may inspect sooner.

Rani Care C.I.C. is a domiciliary care agency providing personal care and support to people in their own homes in the Leeds area. They provide support to older people from all communities. However, they specialise in offering support to people from south Asian communities to meet their specific cultural, language and religious needs. They have a multi-lingual staff team.

Not everyone using Rani Care C.I.C. receives regulated activity; 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. The service was providing personal care to five people at the time of the inspection.

People’s experience of using this service and what we found:

Medicines were not always managed safely. People did not always receive their medicines as prescribed. Risks in people’s homes were not fully assessed to ensure safety. People told us they felt safe and spoke positively of the care and support they received. Staff protected people from avoidable harm, were knowledgeable about safeguarding and felt able to raise concerns. Systems were in place to recruit staff safely. People were supported by a small team of regular staff which provided continuity.

The provider's quality assurance systems were not fully effective. They had not identified areas we found where the service needed to improve. There was a positive culture within the service where people, staff and relatives felt listened to. People and staff were encouraged to provide feedback about the service.

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 supported this practice. Staff received appropriate training and support to enable them to carry out their roles effectively and safely. Staff supported people to access healthcare and maintain nutrition and hydration where they provided this support. People’s needs were assessed before they began to use the service; however, this was not always recorded.

We have made a recommendation about the recording of assessments of people’s needs.

People and relatives told us staff were caring and treated them with respect. People were supported by staff who could communicate in their preferred language. Staff were described as kind and patient. They understood people’s cultural needs and were respectful of this. People were involved in making decisions about their care. Staff promoted people’s independence.

People had care plans regarding their support needs. Some of these needed to be reviewed to include more detail. However, staff knew people's needs, life histories, preferences and routines well. The provider had a system in place for responding to people's concerns and complaints. Any complaints or concerns raised were used as an opportunity to improve the service.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014.

Details of the action we have asked the provider to take can be found at the end of this report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated Good. (published 18 October 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Rani Care C.I.C is an agency providing personal care to people in their own homes in the Leeds area. It is a social enterprise and not for profit organisation. They provide support to older people from all communities. However they specialise in offering support to people from south Asian communities to meet their specific cultural, language and religious needs. They have a multi-lingual staff team.

There was a registered manager in post. 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 requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People who used the service and their relatives all told us they were happy with the support they or their family member received from the service. People told us they felt safe with their care workers and the care they were provided with. They said they received a good standard of care.

All the staff we spoke with and the registered manager showed a commitment to providing good quality person centred care. People told us the service was reliable and staff were kind and caring.

There were systems and procedures in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Staff received training in administration of medicines and systems in place ensured people received their medicines safely. However, some improvements were needed to the records of medication administration to ensure instructions for medications were always clear.

Where needed people who used the service received support from staff to ensure their nutritional and health needs were met.

The registered manager and staff we spoke with had an understanding of the principles and their responsibilities in accordance with the Mental Capacity Act (MCA) 2005.

Care and support was provided by appropriately trained staff. Staff received support and supervision to help them understand how to deliver good care.

There were systems in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident the agency would respond and take action to support them.

There were systems in place to monitor and improve the quality of the service provided. People who used the service, relatives and staff all spoke highly of the registered manager and their commitment to the service and people who used it.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There was an effective recruitment and selection processes in place. Staff received a good induction before they commenced work.

One person we spoke with told us, 'The staff are lovely.' Another person told us, 'I feel safer with their agency as they are able to communicate with me, the last agency could not provide a carer who could speak my language.'

We found adequate quality monitoring systems were in place. This ensured the risks to people were identified and reduced, to be able to continually improve.

Appropriate arrangements were in place to protect people who used the service from the risk of abuse.

Is the service effective?

People's health and care needs were reviewed and care plans detailed how to meet people's needs. The manager told us the plans would be reviewed when needs changed.

One relative we spoke with told us, 'The staff respect my relative and maintain their dignity I am very happy with the service.'

Is the service caring?

We observed care workers interacted positively with people who used the service. Conversations were inclusive and staff gave people time to talk and respond to questions.

One relative told us they were very pleased with the service provided. They told us, 'My relative is very happy with the service it means they are able to stay at home to be cared for and hot have to go into a home.'

Is the service responsive?

Staff we spoke with who provided care to people told us they had been involved in the care plans and understood the care that was required.

The manager told us that if people required changes to the call times this was facilitated. They said they wanted to provide an individualised person centred care package.

One person told us their carer had visited when they were unwell so they had accompanied them to hospital. The carer had stayed with them until a relative arrived. They said, 'I was not left alone.'

Is the service well-led?

The agency is new and had only a few people who used the service; therefore the manager was also working providing care. The manager told us when they have more people who they provide a service to they will recruit additional staff to ensure there was enough staff to meet people's needs.

The staff we spoke with told us they enjoyed working for the agency; they were supported and listened to and the manager was always approachable. They told us they had time to read care plans and understand people's needs.