Redyfne Recruitment and Staffing Limited

Redyfne Recruitment and Staffing Limited is a domiciliary care agency providing care and support to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service was supporting 51 people.

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

People and relatives told us they felt staff had a kind and compassionate attitude. People felt treated with respect and were encouraged to be as independent as possible. Staff knew people well and were able to recognise any change in their needs.

We found concerns around medicines management. There was a lack of systems and processes to monitor and safely manage medicines. Despite our concerns, people and relatives told us they received their medicines safely and on time. People’s risks were not always assessed, and appropriate guidance was not always provided to staff to minimise people’s known risks. There was a lack of auditing systems to ensure oversight of the quality of care being provided and help service improvement.

We have made a recommendation around improving staff recruitment practices.

Staff had been trained in safeguarding and understood how to recognise abuse and who to report to if any concerns were found. People usually had the same care staff visiting them and were able to build a rapport with them. Staff had received training in infection control and had access to PPE. The service followed government guidelines around COVID-19 testing and staff were encouraged to be vaccinated.

Staff were well supported through regular training, supervision and appraisal. People received an assessment prior to the service starting care, this ensured the service was able to meet their needs. Where it was an identified need, people were supported to eat and drink, staff heated up meals or prepared simple meals and snacks. The service made referrals to healthcare professionals when necessary to support people’s wellbeing.

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 were supported to give their feedback on the service and felt the service were easy to communicate with and responsive. The service worked in partnership with other healthcare professionals and made appropriate and timely referrals. Staff felt supported and valued by the management team. There were regular staff meetings to share information and allow staff to voice their opinions.

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 21 March 2019).

Why we inspected

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

We found three breaches of regulation in relation to medicines management, assessing risk and overall governance of the service.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service was supporting 31 people.

Not everyone using Redyfne Recruitment and Staffing Limited receives a 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.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good.

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’s personal risks were well documented. Since the last inspection, more information had been included to provide staff with guidance on how to minimise people’s known personal risks.

There were no people having their medicines administered by care staff. Staff prompted people with their medicines and all staff had received medicines management training.

People received continuity of care and often had the same care staff visiting them. People and relatives told us that staff were generally on-time and stayed the correct amount of time. However, we also received feedback that people did not always receive continuity of care at weekends. We have made a recommendation regarding weekend staffing.

Staff had received training in safeguarding and understood how to recognise and report any concerns.

Staff were aware of how to ensure that people were protected against the risk of infection and had access to gloves and aprons.

Staff were recruited safely. The service completed necessary checks to ensure that staff were safe to work with vulnerable adults.

People and relatives said that they felt safe with the care staff that visited them.

Staff received an induction when starting work and were supported through regular supervision and appraisal.

People were supported to express their views and were actively involved in making decisions about their care. Where appropriate, relatives had been involved in planning people’s care, including pre-assessments prior to receiving care.

People were supported with their nutrition and hydration where this was an identified need. People were positive about the support they received with meals.

Staff were aware of how to report concerns if they noticed a change in people’s health or well-being. People were referred to healthcare professionals where appropriate.

Care plans were detailed and provided enough information for staff to support people. Care plans were regularly reviewed and updated immediately if changes occurred.

People and their relatives understood how to make a complaint.

There were regular staff meetings where staff were able to discuss any issues and receive information about the service.

There were some audits completed to ensure the oversight of the service. However, whist we did not find any concerns around this, the registered manager was not always documenting that these audits were completed.

The service worked in partnership with other agencies and were aware that working with other healthcare professionals was integral to good quality of care.

The Care Quality Commission (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.

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.

This is the first time the service has been rated Requires Improvement.

Risk assessments were in place and people’s individual risks were noted. However, there was no written guidance for care staff on how to mitigate the known risks. People had regular carers and staff that we spoke with were aware of risks to people and how to manage them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the policies and systems in the service did not support this practice. People received regular carers that knew them well and ensured that people had choice but people’s ability to make decisions was not documented in care plans.

Care plans documented care tasks that staff needed to carry out. Care plans did not state people’s likes and dislikes and how they wanted their care to be delivered. However, staff usually worked with the same people and were aware of people’s likes, dislikes and how they preferred their care to be given.

The service did not administer medicines to any people that were supported. However, care workers did prompt people to take their medicines where necessary. Care workers were aware of the difference between prompting and administering medicines.

People received a continuity of care. The provider always tried to ensure that the same care workers looked after people. This promoted good working relationships with people who used the service.

The service was aware of how to ensure infection control when working with people. Staff were supplied with gloves and aprons to ensure that people were safe.

People and relatives were positive about the care that they received.

Staff received regular supervision and appraisal that helped them identify areas for learning and development. Supervisions and appraisals were used as an opportunity for staff to improve care practices.

People and relatives were involved in planning care and reviews of care.

At this inspection we found a breach of Regulations 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Where there were breaches of regulations, you can see what action we told the provider to take at the back of the full version of the report.