Background to this inspection
Updated
28 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 was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
At the time of the inspection the provider was in the process of recruiting a registered manager to be registered with the Care Quality Commission. This means that they and the provider would be legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the nominated individual who was based at the service office, though as a nurse they sometimes covered other staff when necessary. 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 three people’s care records and multiple medicine administration records. We looked at six staff files in relation to recruitment and staff supervision. We also viewed a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We spoke with two people who used the service and two relatives about their experience of the care provided. We also spoke with two further members of staff; both of whom were nurses.
Updated
28 December 2019
About the service
Essex (Realcare Health services) is a domiciliary care agency that provides personal care and treatment for disease, disorder and injury to older adults, children and younger adults 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. They were providing personal care to five people at the time of the inspection.
People’s experience of using this service and what we found
At the previous inspection we found breaches to managing medicines safely and quality assurance. At this inspection we found the service had improved in these areas and were no longer in breach.
The service was able to work with people who were at the end of their life. We have made a recommendation about recording end of life wishes as this was not systematically completed as best practice guidance recommends.
There were safeguarding systems and processes in place that kept people safe. Risks to people were monitored and mitigated against. There were robust recruitment processes in place and sufficient staff to support people. Staff understood the need for infection prevention. The service sought to learn lessons when there were incidents and accidents.
People’s needs were assessed before they used the service to determine if the service could support people or not. Staff were supported through induction, training, and supervision. People were supported appropriately with their nutrition and hydration. Staff worked with other agencies, including health professionals, to provide effective care. 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 well treated and policies and procedures at the service supported equality and human rights. People expressed their views and had input into their care. People's privacy and dignity were respected. People were encouraged to be independent.
People's care plans were personalised and provided instructions, so staff could provide them with care in a way they preferred. People’s communication needs were met. People were supported to partake in activities. People and relatives knew how to make complaints, though there had been no complaints since our last inspection.
People thought highly of the service management. Staff knew their roles and responsibilities. People and staff were able to feedback about the service and be involved with decision making about care.
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 and only previous rating for this service was requires improvement (published 28 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
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.