Right At Home Mid Sussex

Updated 4 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The inspection took place on 24 and 26 January 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we wanted to be sure the office would be open and that staff would be available to speak with us. We visited the office location on these dates to see the provider, the registered manager and other staff and to review care records and policies and procedures. We made telephone calls to people who used the service and their relatives on 29 January 2018, to obtain their views about the service.

The inspection team comprised an 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. The expert by experience at this inspection had experience of older people and of people living with dementia.

Prior to the inspection we reviewed the information we held about the service. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events that the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Prior to the inspection, 10 people were contacted by the Commission and their feedback on specified key questions was recorded in the PIR. We visited two people and one relative in their homes to obtain their feedback about the service and to check the care records that were kept there. We spoke with 13 people by phone, three family members and one member of care staff. We met and spoke with the provider, the registered manager, two members of the administration team, and two care staff. We reviewed a range of records relating to people’s care and support. These included six care plans and associated risk assessments and medicines records. We looked at staff training, support and employment records, audits, minutes of meetings with people and staff, complaints, policies and procedures, accident and incident reports and records relating to the management of the service.

Updated 4 August 2018

The inspection took place on 24 and 26 January 2018 and was announced.

Right at Home Mid-Sussex is a domiciliary care agency. It provides personal care to approximately 45 people living in their own houses and flats in the community. The majority of people receiving a service are older adults with a range of care and support needs and who fund their own care. Not everyone using Right at Home Mid-Sussex receives 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.

A registered manager was 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.

The care and support people received from Right at Home Mid-Sussex was of a high calibre. People felt very safe with staff who supported them and told us they were encouraged to be as independent as possible. People spoke highly of staff and had complete confidence in them; the provider had a pro-active approach in relation to ensuring people’s safety. If they had any concerns in relation to people’s safety, staff knew who to contact and what action to take; they had completed safeguarding training. Risks to people were managed safely and assessments were drawn up before people received support from staff. People were prevented from the risk of infection because staff had completed appropriate training and wore personal protective equipment as needed. Staffing levels were such that staff did not feel rushed when spending time with people. Staff said shifts were organised to accommodate their needs, as well as the needs of people they supported. Safe recruitment systems were in place. Staff had been trained in the administration of medicines and records were completed in confirmation that people received their prescribed medicines. Lessons were learned and improvements made when things went wrong. Staff felt able to raise any concerns they might have in relation to safety incidents and that action would be taken.

We found numerous examples of the kind, caring, warm and outstanding care that people received from staff. People and their relatives spoke positively about staff and were extremely happy with the care they received. Staff encouraged people in their independence so that people felt in control of their lives. Staff went the extra mile in relation to people’s wellbeing and the help staff provided went beyond the hours they were contracted to deliver. People’s needs were paramount and staff were highly motivated to provide the care and support people wanted. Relatives who cared for their loved ones were not forgotten and care was provided that fitted in with relatives’ needs, as well as people being cared for. People were involved in all aspects of their care and felt that staff treated them with dignity and respect in a discreet and sensitive way. The provider recruited staff who had the right values and attitude towards providing high quality care. A relative said, “They are very kind to him, very respectful and they always do jobs over and above what is in the plan. I’ve never felt worried about how they were treating him, they are so gentle and patient with him. They chat to him and try to get to know him. I hear them laughing with him. They are very tender-hearted”.

Care plans were detailed and people were fully involved in drawing–up and reviewing their care plans. People were carefully matched with staff who would be looking after them. People felt they received good quality, personalised care and that their preferences were met. The service was responsive to people’s changing needs and people described the kind of care and support they received, which was bespoke to them. People were encouraged to go out into the community and to engage in activities that promoted a sense of well-being and were meaningful. People and relatives knew who to contact if they had any concerns or complaints and felt confident these would be addressed.

The service had been in operation just over a year at the time of this inspection and was growing steadily. Staff felt valued working for the provider and said their professional and personal needs were catered for. Staff were passionate about their work and about the people they supported. They were asked for their views and suggestions and contributed to the development of the service. Questionnaires were sent to people and their relatives to obtain their views about the service. All comments were extremely positive and a home care website scored the service 9.9 out of 10 on average. People felt fully informed and engaged with the service and were extremely likely to recommend the service to others. The service was well managed and well led. A range of audits was effective in measuring and monitoring the quality of care delivered. The provider met with other regional managers who worked for the brand ‘Right at Home’ and was keen to set up a local managers’ forum.

Staff completed a range of mandatory training to carry out their roles and responsibilities. They received regular supervision meetings and had a good understanding of equality and diversity. People and relatives felt that staff were well equipped and trained to do their jobs. New staff completed an induction programme and shadowed experienced staff. There were opportunities to study for additional qualifications if staff wished. Some people required help in the preparation of meals and staff supported them with this. People were encouraged to live healthy lives and staff liaised with healthcare professionals as needed. The service was working within the principles of the Mental Capacity Act 2005 and staff had completed training on this topic. People’s consent was gained lawfully.