We carried out a review of the data available to us about Right at Home Worthing & Shoreham District on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Right at Home Worthing & Shoreham District, you can give feedback on this service.
Right at Home Worthing & Shoreham District is a domiciliary care agency (DCA) and it provides personal care to people living in their own homes. It provides a service to support people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with long-term health related conditions. The DCA provides 'live-in' support for people who want care staff available throughout the day and night. At the time of this inspection the service provided personal care to 18 people.
'Right at Home' is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's products in a particular area using the company's name.
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 said they felt safe and were protected from harm. A person said, "I feel very safe. They [staff] have got to know me, what my care needs are and do that safely.”
Staff had a good understanding of what safeguarding meant and the procedures for reporting any issues of harm to people. All the staff we spoke with were confident any concerns they raised would be followed up appropriately by the registered manager.
Staffing levels were specific to individuals. A person said, “I have a superb service, because of the calibre of staff. I mostly have the same staff and have had for 3 years. They are never late, and I have never had a missed call. My main carer, who I have five days a week, is now more of a friend than a carer. I like my calls early, at 7am. This gives me the rest of the day for myself and this time has never ever been a problem.” The staff recruitment procedures ensured appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.
Medicines were managed safely by trained staff. Effective practices were in place to protect people from infection.
Staff received supervision and appraisals to support them in their role and identify any learning needs and opportunities for professional development. Senior staff carried out spot checks on staff to monitor the quality of the service provided and to seek the views of the people who were supported.
Staff supported people to have enough to eat and drink and to make choices about what they ate and drank. A person said, “They make my meals for me, we plan this together to make sure certain foods are taken out the freezer in time. They are always thinking ahead to make sure I have enough stock in the cupboards and fridge so I don’t go hungry.”
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 received appropriate healthcare support as and when needed and staff knew what to do to summon assistance.
People were supported by kind and caring staff who knew them well. People spoke highly of the staff who looked after them and said they were treated with dignity and respect. A person said, “The staff really care for my modesty. And treat me with respect. We have a laugh and a joke. They always encourage me to do what I can do. I can wash certain parts of my own body, and they allow me to do this, they respect this.”
People were involved in all aspects of their care and were supported to express their views. Complaints were investigated and managed appropriately in line with the provider's policy.
The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them. The service worked in partnership with other agencies to ensure quality of care across all levels. People, relatives and staff were encouraged to provide feedback about the service. There was a culture of openness and transparency. Staff were positive about the management and leadership of the service.
The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.
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 Requires Improvement (published 5 December 2018).
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.
Right at Home Worthing & Shoreham District is a domiciliary care agency (DCA) and it provides personal care to people living in their own homes. It provides a service to support people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with early and advanced stages of a dementia type illness or other long-term health related condition. The DCA provides 'live-in' support for people who want care staff available throughout the day and night. At the time of this inspection the service provided personal care to 34 people.
‘Right at Home' is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's products in a particular area using the company's name.
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 registered provider had a safe recruitment system to ensure suitable staff were selected to support vulnerable people. However, we found one employee record which did not contain a full employment history.
The provider did not always work within the principles of the Mental Capacity Act (MCA). Capacity assessments and best interest decisions were not always in place where required. Care records lacked detail on the specific decisions people who were assessed as lacking capacity would require support to make. Staff told us they sought people's verbal consent before they provided care and support and recognised this was an important part of their role in promoting choice and independence. We recommended the registered manager reviews their processes in line with the MCA 2005 Code of Practice, when establishing whether people are able to make decisions regarding their care planning and the delivery of care. We also recommended the registered provider review their processes for obtaining consent so this is completed before care and treatment is provided.
Care plans contained risk assessments which identified potential risks to people. However, care plans were not always person centred and did not always contain important information relating to people’s specific needs, for staff to provide consistent care. Feedback obtained during the inspection showed people received appropriate care and treatment.
The provider's systems to monitor the quality of the service had not always been effective to identify shortfalls identified at this inspection. We recommended the provider review all records to ensure they were accurate and up to date in line with best practice.
People were protected from harm. Staff received training and understood how to recognise signs of abuse and who to report this to. Staffing levels were sufficient to provide safe care. When people were at risk, staff had access to assessments and understood the actions needed to minimise harm. The service was responsive when things went wrong, were open and reviewed practices and had a robust system in place to manage incidents. Medicines were administered and managed safely by trained and competent staff. The management team carried out weekly audits of Medicine Administration Records (MAR).
People and their relatives had been involved in assessments of care needs and had their choices and wishes respected, including access to healthcare when required. The service worked well with professionals such as nurses, doctors and social workers. The provider actively sought to work in partnership with other organisations to improve and nurture positive outcomes for people. Care and support was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. Staff felt supported by the registered manager.
People and their relatives described the staff as caring, kind, and compassionate. People could express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected and staff understood their responsibilities in relation to this.
The service had an effective complaints process and people were aware of it and knew how to make a complaint. People and their relatives told us they felt confident their concerns would be addressed. The service actively encouraged feedback from people. No one was receiving end of life care at the time of the inspection.
The service had an open and positive culture. Leadership was visible in the service and promoted inclusion. Staff spoke positively about the management team and felt supported by them.