Rysvil Care Services Limited

Rysvil Care Services Limited is a domiciliary care agency providing personal care to people living in their own homes.

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 this inspection 30 people were receiving support with personal care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location provided care and support for 3 people with a learning disability. We assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support

Staff supported people to have full choice, control, and independence over their lives There were systems in place to safeguard people from potential harm. Staff completed training about safeguarding and knew how to report abuse. Risks to people using the service were assessed and strategies were put in place to reduce the risks.

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. Effective systems were in place to closely monitor incidents and prompt action was taken to mitigate the risk of repeat incidents.

Right Care

People received care and support that was personalised and provided by a staff team who were well trained and well supported. Comments from people who used the service and relatives were complimentary and consistent stating they were happy with the care, treatment and support the service provided. Reviews of people’s care were held regularly to ensure their care was regularly assessed and updated if changes were needed.

Right culture

The service promoted a culture of inclusion, diversity, and equality. People and those important to them, were involved in planning their care. Staff supervision, staff meetings and spot checks were undertaken regularly and used to develop and motivate staff, review their practice, and focus on professional development. There was good management oversight of the service. A range of quality assurance audits were in place and were effective at identifying concerns or areas for improvement.

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 16 April 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 remained Good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rysvil Care Services Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

People told us they felt safe and thought that staff were kind and caring.

The registered manager had systems and processes in place ensuring risks were well managed and care was personalised and reviewed.

Staffing levels, skills and experience were suitable to meet the needs of people.

The provider implemented safe systems for the management of medicines which included staff training and assessments of staff competency.

Staff had a good understanding of preventing the spread of infection by using the protective equipment and good hand hygiene.

The registered manager shared lessons learnt with staff and managed complaints and concerns in an open and honest way.

People told us they felt involved and listened to. They also said staff respected their wishes and preferences.

Staff supported people with meals and drinks and supported to access specialised healthcare when needed.

Overall care visits were prompt. However, some people told us staff were sometimes late with care visits which was a concern for them. People told us they were talking to the registered manager about this.

The registered manager used systems such as training, policies and care plans to ensure that staff had the skills and knowledge to support people who needed end of life care in the future.

The registered manager and the staff team were clear about their roles and the impact of good care.

The registered manager showed ways that they are working with other agencies and providers to share ideas and improve services.

The service met the characteristics of good all areas. 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 inspection report was published on 07/04/2016. The service was rated as Good in all five key areas of safe, effective, caring, responsive and well-led. The service received an overall rating of good at the last inspection.

Why we inspected: This was a planned comprehensive inspection based on the date the last inspection report was published.

Rysvil Care Services Ltd is a domiciliary care agency providing personal care to people in their own homes in the Luton area. At the time of our inspection there were 23 people using the service.

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 2008 and associated Regulations about how the service is run.

People using the service were kept safe from risk of harm and staff understood the ways in which they could be safeguarded from abuse. Risk assessments were robust and detailed enough to minimise any risk to each person and contained sufficient information to ensure that people’s dietary and healthcare needs were being met where necessary. Satisfaction surveys were sent out to ensure that people were happy with the care they received, and improvements were made on the basis of people’s feedback.

Staff received the correct training to undertake their duties effectively, and received supervisions and performance reviews to support their continued development. Staff understood their roles and responsibilities and were knowledgeable about the ways in which people gave consent and how the Mental Capacity Act was applied in practice. Staff demonstrated a caring attitude and understood how to treat people with dignity and respect. Staff meetings were held regularly and provided an opportunity for the team to meet and discuss issues affecting the service. New staff received a full induction into the service, and robust recruitment procedures were in place to ensure they had the skills and experience necessary for the role.

People’s backgrounds, social histories, preferences and cultural needs were included in their care plans and they were involved in reviews and meetings about issues relating to their care. Where people required support with administration of their medicines, the service kept appropriate records and information on their file. Quality audits were completed regularly to ensure that the service was identifying any areas for improvement and taking appropriate action to resolve them. People and staff were positive about the manager of the service and shared her visions and values. People knew who to complain to if necessary, and the manager had an effective system in place for handling and resolving complaints.

We found that improvements had been made to the service's recruitment procedure. This ensured that the recruitment procedure was effective and people were cared for, or supported by, suitably qualified, skilled and experienced staff.

The complaints process had been reviewed to ensure that the complaints system was effective and complaints were investigated within the agreed timescale and to people's satisfaction.

We found that people's needs had been assessed to ensure the care they received was safe and effective.

The agency had procedures in place to ensure that people were protected against the risk of acquiring a health care associated infection. There were arrangements in place to ensure equipment used by people was properly maintained.

We found that the agency did not have effective recruitment procedures to ensure appropriate checks were undertaken before staff commenced work.

The agency had a system in place to assess and monitor the care provided to people. We found that the complaints procedure was not effective. Therefore, people could not be assured that their complaints would be responded to appropriately.

The provider wrote to us on 16 November 2012 and told us that they had implemented an audit check list and this would be completed on a twice yearly basis. In addition they would complete an annual service satisfaction survey to gain feedback from people using the service. We looked at these and found them to be fully completed and up to date.

We found that systems had been implemented to improve the way in which the service assessed and monitored the quality and safety of care for people using the service.

We were told that staff were reliable and professional. One person said 'The staff never talk about other people using the service so I feel secure they don't talk about me to other people.' One person using the service told us they were very happy with the care they received. They said the staff were so helpful and because of this they were able to stay in their home without having to worry.