Background to this inspection
Updated
18 December 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. 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
The inspection team consisted of one 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.
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 and to gain people’s consent to be contacted by an inspector or the Expert by Experience for their views on the service.
Inspection activity started on 28 October 2019 and ended on 29 October 2019. We visited the office location on 29 October 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included an action plan that the provider sent on 2 January 2019 following the previous inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and one relative about their experience of the care provided. We spoke with six members of staff including the registered manager, a care coordinator, three care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included seven people’s care records. We looked at three 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.
Updated
18 December 2019
About the service
Regal Home Care is a domiciliary care agency providing personal care to 77 people at the time of the inspection. 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
Management of the service had changed since the last inspection. The new registered manager had made improvements and positive changes were already embedded within practice. Staff demonstrated a clear understanding of safeguarding, and incidents had been reported to the local authority in line with safeguarding policy. Risks were now assessed and managed consistently to support people to be safe. Systems for administering medicines were safe. There were enough suitable staff to provide the care visits that people needed. People told us they felt safe because the service was reliable. One person said, “They never let me down.”
Improvements in planning care visits meant that people were receiving a more responsive service. People told us their visits were usually punctual, with familiar staff. People were kept informed of changes. Care plans were detailed and supported personalised care, including for end of life care. People described improvements in the consistency of the service. They knew how to complain and were confident their concerns would be addressed.
Systems for monitoring the quality of the service had improved. The registered manager demonstrated clear oversight of the service. Actions had been taken to address previous concerns about record keeping, safeguarding people, poor punctuality and consistency. The provider had a clear development strategy to drive improvements. Staff spoke positively about the changes that had been made and planned improvements that were being implemented.
Staff were receiving the training and support they needed. People had confidence in the skills of the staff. One relative said, “They are all well trained, very good, they communicate with us very well.” 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. Staff supported people to have enough to eat and drink and to access health care services when they needed them. Communication systems were effective and staff worked collaboratively with other agencies to deliver effective care.
People spoke highly of the service and said the staff were kind and caring. One person told us, “They are fantastic, nothing they won’t do for you.” Staff knew people well and supported them to be involved in planning their care and support. One person told us, “I feel in control of the care I need and how it’s provided.” Staff respected people’s dignity and understood the importance of maintaining their confidentiality. People were supported to remain as independent as possible and a person described the impact of this support, saying, “The care has made all the difference to me being able to stay home and still do what I can for myself.”
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 12 December 2018) when there were three breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected.
This was a planned inspection based on the previous rating.
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.