We carried out a review of the data available to us about Rehoboth Health and Home Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rehoboth Health and Home Care Limited, you can give feedback on this service.
Rehoboth Health and Home Care Ltd is a domiciliary care service providing personal care to people in their own home. At the time of the inspection, 19 people were receiving support from the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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
People and their relatives told us they felt safe when being supported, and staff treated them with dignity and respect. Staff understood their role to report any safeguarding concerns and accidents and incidents to the managers.
Improvement had been made to the assessment and management of people’s risks, medicines and associated records.
People’s prescribed medicines were being safely managed. The deputy manager was planning to review people’s non-prescribed medicines, such as barrier creams to ensure they were safe to use.
Staff had access to people’s care plans and guidance on how they should support people to mitigate risks.
Some relatives raised concerns about the variable times of people’s care calls which was discussed with the deputy manager. They explained recruitment of staff had been a challenge for the service and were actively recruiting new staff.
Improvement had been made to the provider’s quality assurance systems. However, the deputy manager recognised that further development was needed in the monitoring of people’s care records to ensure all records were consistently detailed.
People received care and support which was personalised and met people’s needs. The deputy manager had a good insight into people’s care delivery and staff practice as they frequently delivered care to people and worked alongside staff.
The provider and deputy manager valued people’s feedback and told us they would respond promptly to any complaints in line with the provider’s policies. Relatives confirmed the managers were responsive to people’s concerns.
People were supported by staff who had been trained as part of their induction to carry out their role. The provider was considering their induction and additional training for staff which would support and confirm any skills acquired in their role, such as catheter care.
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 22 June 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do to improve, and by when. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rehoboth Health and Home Care Limited on our website at www.cqc.org.uk.
Rehoboth Health and Home Care Limited is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 20 people were supported with their personal care needs.
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
This service was registered with CQC in July 2020. Since registration, the service had implemented a new electronic care management system to assist the managers in monitoring the service in ‘real time’. However, the provider was unable to fully demonstrate that people’s care needs were being fully met as not all staff were consistently using the systems in line with the provider’s requirements.
Whilst the deputy managers delivered care and had some oversight of the service, the registered manager had failed to ensure that effective systems were in place to assist them in monitoring the quality of the service, drive improvements and improve people’s experiences of the service.
People were at potential risk as staff did not always have access to information on how to mitigate people’s personal risk and how staff should support people in managing their medicines. Risk management and medicines care plans did not comprehensively describe the actions staff should take to minimise risks to people and the support people required to safely manage their medicines.
New staff were given opportunities to shadow more experienced staff and completed an intensive one-day course as part of their induction. Spot checks and observations of staff visits in people's homes were carried out. However, there was limited evidence that the skills and knowledge of staff when supporting people with their risks and medicines had been robustly assessed as being competent.
People reported that staff had good infection control practices and wore the appropriate PPE; however, the provider was not routinely monitoring the COVID-19 testing and vaccination of staff and implementing extra measures where required.
People were supported by staff who were familiar with their needs, however some people and their relatives felt staff could be more punctual as they sometimes arrived late which impacted on their well-being. Some relatives felt that communication relating to their concerns and punctuality of staff could improve.
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. However, we have recommended that the service seeks advice and guidance from a reputable source in relation to mental capacity assessments and best interest decisions to ensure the provider gains people's lawful consent to the care being provided.
Safe recruitment practices were being used, however further evidence of the registered manager’s assessment of an applicant’s good character was required when there was limited background information made available to them.
Staff we spoke with told us they understood their roles and responsibilities and felt supported by the registered and deputy managers.
People and relatives, we spoke with said they felt safe when staff visited them. They told us staff were friendly, cheerful and treated them with dignity and kindness. People’s care plans detailed some of their preferences and backgrounds.
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 in July 2020 and this is the first inspection.
Why we inspected
This service had not been inspected since their registration; therefore, this inspection was carried out to gain assurances about the quality of care and systems used to monitor and the manage the service.
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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the safe care and treatment of people and the management 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 request an action plan for the provider to understand what they will do to improve the standards of quality and safety.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.