Rapid Improvement Care Agency

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Based on the findings of this assessment we found no issues. This meant people remained safe and protected from avoidable harm. Staff were usually punctual for their scheduled calls and let people know if they were running late. Staff were appropriately trained and supported. Staffs’ suitability and fitness to work in adult social care was also thoroughly assessed. Staff understood how to safeguard people. People were cared for and supported by staff who knew how to manage risks they might face. Medicines systems were well-organised, and people received their prescribed medicines as and when they should. Staff followed current best practice guidelines regarding the prevention and control of infection including, and those associated with COVID-19.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have done better. People told us when they made a complaint or raised a concern, managers and staff listened and acted upon their feedback.

Managers and staff told us incidents and accidents, safeguarding concerns, formal complaints and any stakeholder feedback received, were always logged and analysed. These incidents were routinely reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. The registered manager gave us a good example of how lessons had been learnt and appropriate action taken to improve how they now coordinated and monitored call visits. The provider had introduced a new system that could now identify staffs exact whereabouts at any given time while they were at work in response to several incidents of carers logging in and out of call visits they had not actually attended. Staff told us information about any incidents and lessons to be learnt were always shared with them at individual and group team meetings and training sessions.

The provider learnt lessons when things went wrong. The office-based managers and senior staff continually reviewed incidents and accidents, and safeguarding concerns to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons. This information was shared and discussed with staff during individual and group meetings. The provider used feedback as a way to improve the service, this included acting on any feedback they had received from people. Provider had improved their electronic call monitoring system to enable the office-based managers and staff to identify staffs whereabouts during their scheduled call visits.

People told us they were invited to participate in an assessment process prior to them receiving a home care or supported living service from this provider. People said they received the personal care and support that had been agreed in their care plan.

Managers told us people's personal care needs were assessed before they were offered the opportunity to receive a service from this provider. Managers confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

Managers told us they carried out assessments to ensure people that had been referred to them were suitable for a placement at their supported living scheme or to receive personal care at home. External care professionals told us the provider collaborated with them to establish and maintain safe systems of care.

Care and risk management plans were in place for people, and these included any assessments that were received from the referring agency. For example, we saw care and support plans from the local authority which had been given to the provider when they had first received the referral from them. There were also easy read tenancy agreements in place for people receiving a supported living service, which showed they and people who supported them were involved in this process.

People told us they felt safe with the staff who supported them at home with their personal care. A person said, “I do feel safe with the staff who look after me at my home. They are all lovely and very caring,” A relative added, “The service is absolutely safe. We feel safe when they [staff] are here.” An external care professional also remarked, “I’m very confident the managers and staff take any allegations of abuse or neglect very seriously and handle them promptly and professionally.” We also observed people who received a supported living service looked at ease in the presence of staff.

Managers and staff protected people from abuse. Staff received safeguarding adults training as part of their induction which managers and staff confirmed was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would make sure I report any abuse or neglect I suspect has happened or that I witness immediately to my line manager, as well as the CQC.” Staff were routinely reminded about their safeguarding roles and responsibilities at individual or group team meetings with their line managers and fellow co-workers. The office-based managers and staff understood they had a duty of care to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police. Staff told us they were confident any concerns raised about abuse would be appropriately dealt with my the managers. The registered manager confirmed there were currently no ongoing safeguarding concerns that were being investigated.

Robust systems and processes were in place to protect people from the risk of abuse. The provider had clear safeguarding and staff ‘Speak up’ policies and procedures in place which were kept up to date and were in line with relevant legislation. These policies and procedures were also easily accessible to all staff via the staff handbook which they had all been supplied with. Care plans included a ‘safety plan’ for people, giving staff guidance on potential warning signs that would indicate if people were unsafe and also how to keep them safe. Managers worked well with external agencies including, local authorities, the CQC and the police where necessary, and acted in a timely way to ensure people were safeguarded and protected from further risk. An external health care professional gave us a good example of how well the provider had managed a safeguarding incident their client was involved with.

People told us care staff knew how to support them in a safe way that helped prevent and/or minimise the risks they might face. A person said, “They [staff] always talk through with me what they are going to do to look after me and keep me safe.” External care professionals also said they were generally happy with the way staff supported their clients to stay safe and manage potential risks. An external health care professional remarked, “Staff are trained in safe moving and transferring techniques. They follow established best practice guidelines to ensure the safety and comfort of my clients during transfers, minimising the risk of injury.” Another added, “Staff implement my clients Positive Behaviour Support (PBS) plan and up dated it following several incidents to ensure they were able to continue safely meeting my clients behavioural support needs.”

Care staff were aware of people's daily routines, preferences and needs, and knew what action to take to reduce or safely manage risks people they supported might face. Staff spoke about a person they supported who could sometimes become distressed. These staff said they were happy with the guidance they had been provided by external care professionals to prevent or appropriately manage such incidents. A member of staff remarked, “I am aware of the potential risks our clients face, particularly regarding moving and handling, falls, and pressure sores, and I follow established protocols to prevent or manage these risks safely.” Another added, “I know how to keep the people I regularly look after with known mobility needs safe. We do this by conducting falls, skin integrity, and moving and transferring risk assessments, and regularly updating our moving and transferring, and pressure sore prevention and management training.”

People's care plans contained up to date risk assessments and management plans that ensured staff had access to all the relevant information and guidance they needed to know about how to prevent or appropriately manage risks people might face. They included risk assessments and management plans associated with people’s home environment, controlling infection, safely managing medicines, moving and transferring, preventing falls and pressure sores. Positive Behaviour Support (PBS) plans were also in place for people who required them, which had been developed by external behavioural specialists. It included information about people’s behaviours and how to manage them. For example, it included a behavioural crisis plan and contained details about what a good and bad day looks like so staff could support people to have a good day. All the risk assessments and management plans described above were regularly reviewed and updated as people's needs changed.

People using the supported living service told us they lived in a home that was safe.

Managers and staff told us people lived safely in the supported living home which was managed by a housing landlord. They said they had a good relationship with each other and they were quick to resolve any housing issues such as repairs that were needed.

There were effective arrangements to monitor the safety and maintenance of the premises where people receiving a supported living service resided. Regular maintenance checks were carried out by both the care provider and the landlord. For example, in relation to fire safety we saw personal emergency evacuation plans were in place to help staff evacuate people safely in an emergency. The care provider carried out regular fire drills. The landlord completed monthly maintenance checks on the property.

People told us that staff never missed scheduled call visits, were usually on time, and always informed them if delayed. They noted that staff completed all tasks without rushing, as per agreed care packages. One person said, “Staff arrive more or less on time and always stay for the allocated time.” A relative added, “We’ve never had missed calls. Staff may occasionally be late due to traffic, but they always let me know. The office manages the call visits well.” An external healthcare professional stated, “I haven’t received complaints about staff punctuality. They prioritise being on time and ensuring clients receive their agreed care.” People receiving supported living services also confirmed that sufficient staff were always available, both at home and in the community. One person said, “There is always someone here to help us when we need them.” Continuity of care was a recurring positive theme. People highlighted having a consistent group of staff familiar with their needs, preferences, and routines. A relative said, “We predominantly get the same carers, and the continuity is great.” Another relative shared, “We usually have four carers who rotate, which is ideal as you get to know them well.” An external professional commented, “My clients have the same staff group, ensuring consistent care and fostering trust and comfort.” Staff’s knowledge and skills were also praised. A relative observed, “The service trains its staff regularly, and you can see the provider invests in their development.” An external professional added, “Staff are well-trained, competent, and committed to ongoing development, ensuring they stay updated on best practices.”

While a few staff expressed concerns about how call visits were occasionally coordinated by office-based managers, the majority reported that call visits were generally well-managed. Typical comments included: “Sometimes not enough time is allocated for a call, so we occasionally run late for the next one,” “Call visits are typically well-planned, allowing me to arrive on time and complete all tasks as agreed,” and “The office often provides more than enough time to complete everything as planned.” Staff noted they were usually assigned to a regular group of people in the same local area, ensuring continuity of care. Managers highlighted that supported living services had a dedicated team providing 24-hour staffing, including overnight 'sleep-in' staff and one-to-one support for community access. Training was refreshed regularly to ensure staff maintained up-to-date knowledge and skills relevant to their roles. This included annual training on dementia awareness, moving and transferring, and end-of-life care, as well as specialist topics such as learning disability awareness, positive behavioural support, and epilepsy management for those supporting individuals with specific needs. Staff demonstrated a strong understanding of their responsibilities. One staff member said, “Before starting, you must complete the Care Certificate induction, which is refreshed annually.” Staff were supported to reflect on and improve their practices through quarterly supervision meetings, a minimum of six spot-check observations annually, and an appraisal of their performance over the previous 12 months. A staff member commented, “The management conducts regular supervisions and spot checks, helping us ensure we continue to deliver good quality care.”

Since the last inspection, the provider introduced an electronic call monitoring (ECM) system to coordinate and monitor staff call visits. This system logs staff arrival and departure times and alerts office-based managers in real time if staff are running late, leave early, or miss a call. ECM data is reviewed continuously to ensure timely interventions where necessary. To improve punctuality, the provider formed ten new care teams based on the proximity of people’s homes, enabling staff to work locally. Additionally, the provider purchased ten vehicles for these teams, with designated drivers responsible for ensuring timely call visits. People received consistently good care from a dedicated group of staff familiar with their needs, preferences, and routines. Training records confirmed staff attended relevant courses, refreshed regularly to ensure alignment with best practices. New staff completed a comprehensive induction mapped to the Care Certificate, which included shadowing experienced staff to build confidence and competence. Staff recruitment processes were robust, with thorough pre-employment checks conducted. These included identity verification, employment history, character references, right-to-work verification, and Disclosure and Barring Service (DBS) checks to ensure staff suitability.

People told us staff who provided their care and support always wore appropriate personal protective equipment [PPE]. A person said, “They [staff] are just superb when it comes to hygiene and food preparation.” People using the supported living service also told us staff helped them to keep their home environment clean.

Managers and staff told us they had received up to date infection control and food hygiene training. A member of staff said, “We have access to all the necessary protective personal equipment and we have regular COVID-19 tests in order to keep the staff and people we support safe.” Managers also told us they had ample stocks of PPE which they kept in their offices, which care staff could easily access as and when required. We observed staff visit the providers offices during our assessment to collect PPE stored there.

The provider followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider had an up-to-date infection prevention and control policy in place. The provider also followed good practice in relation to maintaining the home environment where people receiving a supported living service resided, including risks in relation to infection control. Regular checks took place which helped to ensure their home environment was kept clean.

People who received assistance from staff to help them manage their medicines told us staff always ensured they took their prescribed medicines as and when they should. A person said, “They [staff] give me my medication on time.” A relative added, “They [staff] are just superb when it comes to administering my [family members] medicines. They are very professional and double check everything.” An external care professional also said, “Staff follow established medicines protocols and ensure my clients receive their medicines as they are prescribed.”

Staff were clear about their roles and responsibilities in relation to the safe management of medicines. Staff received medicines training as part of their induction and their competency to continue managing medicines safely was assessed by managers at least annually or more frequently if required.

Most people’s care plans included detailed guidance for staff about their prescribed medicines and how they needed and preferred them to be administered however, protocols for the use of ‘as required’ behavioural modification medicines were not always sufficiently detailed. This meant staff might not have access to all the information they need to know when and how to safely administer this type of medicines. In addition, Medication Administration Records (MAR) charts were also not always clear when ‘as required’ medicines were offered and/or refused, and this type of medicines were not always routinely counted. We discussed these issues with the registered manager and they responded immediately after the assessment. They confirmed all the actions they had agreed to take to improve guidance for staff in relation to safely manage ‘as required’ medicines had now been completed and the issue rectified. For example, they submitted records after the site visit which included some guidelines from the GP and also amended their MAR charts so staff could tally the medicines count after each administration. We found no recording errors or omissions on any of the medicines records we looked during this assessment.