Edith Healthcare Ringwood

Edith Healthcare Ringwood is a domiciliary care agency. It provides personal and nursing care to people living in their own homes. At the time of this inspection nine people were receiving the regulated activity of personal care and nursing care from the service. 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.

People’s experience of using this service and what we found

Improvements had been made in the recruitment of staff and in the governance systems which monitored how the service recruited staff. There were enough experienced staff to meet people’s needs. Safe recruitment practices were followed and appropriate checks completed to ensure that only suitable staff were employed.

People, relatives and health care professionals spoke positively about the service Edith Healthcare Ringwood provided. People received personalised care which was responsive to their individual needs. Staff had a good understanding of the care and support people needed and provided this with care and compassion.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice. Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of avoidable infection.

Staff supported people to take medicines safely. Staff were trained in medicines management and knew how to ensure that people received their medicines on time and as they had been prescribed.

Staff received induction and on-going training and support that enabled them to carry out their roles effectively.

Close working partnerships with other agencies and health professionals had been formed which ensured people received appropriate care and support.

People and relatives knew how to raise any concerns and felt they would be addressed appropriately.

There was a system of ongoing monitoring through audits and spot checks to review the quality of the service provided.

People, staff and relatives expressed confidence in the management team. People felt the service was well led and specifically praised the service given by the registered manager.

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 18 June 2019) where a breach of regulation relating to recruitment was identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions, safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Edith Healthcare Ringwood on our website at www.cqc.org.uk.

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.

People’s experience of using this service: The registered manager had not ensured that all of the required checks had taken place before staff were employed.

The systems in place had not been fully effective in assessing, monitoring and improving the quality and safety of the service.

Whilst there was a culture of openness and transparency within the service, there was no robust system in place to record safety concerns, incidents or near misses such as falls or medicines errors.

Best practice frameworks for the safe management of medicines needed to be further embedded.

Some aspects of the premises were not entirely suitable for the purpose for which they were being used. We have asked the registered manager to undertake a robust risk assessment and continue to review this to assure themselves that they are meeting their obligations under Health and Safety at Work Legislation.

People were supported to have maximum choice and control of their lives and staff supported them in their best interests; the policies and systems in the service supported this practice.

There were sufficient numbers of care workers available to meet people’s needs and the service they received was reliable with good continuity of care.

Systems and processes were in place to safeguard people from the risk of abuse.

Good practice guidance was followed to ensure infection prevention and control processes were

implemented.

People felt their needs were met effectively and everyone was happy to recommend the service to others.

Staff felt well supported and received an induction and regular training opportunities to keep their knowledge up to date.

People’s nutritional needs were met.

Staff liased with other health care professionals to help ensure people received timely and effective healthcare.

People were supported by staff who were kind and caring. People received regular and consistent care workers which meant they were able to develop meaningful relationships with them.

Staff displayed a genuine desire to enhance people's wellbeing and spoke of the importance of making a difference to people’s lives and helping them to remain in their own homes.

People had a choice about all aspects of their care including the preferred time of their care calls and the level of support they required. Relatives praised the way in which staff worked in partnership with them to meet people’s needs.

Staff helped and encouraged people to stay independent. Each person was treated with respect and the support they received helped to maintain their dignity.

All of the staff we spoke with were knowledgeable about people's individual needs and were able to talk at length about people’s preferences and preferred routines. This helped to ensure that people received care that was personalised and responsive to their individual needs.

The care being provided was having a positive impact on people and there were examples of staff going above and beyond to support people.

People and their relatives had been asked to share their views about the quality of care they received. They were confident that any concerns or complaints would be listened to and acted upon.

Feedback about end of life care was positive. End of life care planning was an area which could be further developed to ensure these provided a fully person centred record of people’s known wishes and preferences.

The registered manager and staff worked well together to ensure the effective day to day running of the service.

It was a central part of the registered manager’s vision for the service that it retained a strong emphasis on person centred care and this was a strength of the service.

People, relatives and staff were positive about the leadership of the service and told us the registered manager was approachable and supportive.

The registered manager supported the development and learning of staff which meant people received effective support from staff.

The registered manager continued to practise as a registered nurse and undertook periodic shifts in clinical settings to continue to practice their skills, knowledge and experience as a registered nurse. However, we have made a recommendation that they ensure they have access to ongoing and regular clinical or professional supervision and that a suitable programme of mentorship is in place and documented.

Why we inspected: The inspection was a scheduled inspection based upon our methodology for newly registered services.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see what action we have taken at the end of this report.

Follow up: Going forward we will continue to monitor this service and plan to reinspect in line with our re-inspection schedule for those services rated ‘Requires Improvement’.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk