Ryan's

Updated 8 January 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by two inspectors 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. providing care and support to people living in 11 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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

This inspection was unannounced.

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. 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 five people who used the service and five relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, directors, compliance officer, and care workers.

We reviewed a range of records. This included seven 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 2022

About the service

Ryan’s is a domiciliary care agency providing personal care to people living in supported living properties. 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. At the time of inspection 11 people were receiving personal care.

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

Medicine management required improvement. Medicine administration records were not consistently completed, and we found errors in the recording of medicines.

Mitigating known risks to people had not been consistently recorded. Strategies put into place to the reduce the risk of harm to the person had not always been recorded.

Care plans did not always contain sufficient or factual information. Records of when support was offered or completed with a person were not consistently completed.

Oversight of the service required improvement. Audits were not always effective in identifying when records were incorrect or incomplete.

People were protected from the risk of abuse. Systems and processes were in place and staff were trained and understood safeguarding procedures. People told us they felt safe.

People were supported by staff who knew them well, had appropriate training and who had been safely recruited.

People were protected from risks of infection. Staff wore appropriate Personal protective equipment and received training in infection prevention and control.

People were supported to access healthcare services as required. The registered manager made referrals to healthcare professionals as needed.

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 and relatives were happy with the care and support they received. People told us staff were kind and responsive to their needs and staff respected their dignity and privacy.

People and their relatives were involved in the care planning process. People were supported to maintain relationships that were important to them.

Staff communicated with people in their preferred method. People were able to feedback their views on the service. People, relatives and staff all knew how to complain and felt listened to by the registered manager.

The registered manager was open to feedback and was committed to improving care. Staff and management worked in partnership with others to learn and improve.

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

Rating at last inspection

This service was registered with us on 15 May 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding concerns. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.