4 April 2023
During an inspection looking at part of the service
New Hope Care Rutland is a domiciliary care service providing personal care to people living 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. At the time of our inspection there were 20 people receiving personal care.
People's experience of using this service and what we found
Risks for people were not consistently assessed and planned for. There was a lack of information about how risks associated with people's needs might impact on the care being provided. Staff did not always respond to new risks or changes in people's needs in a timely manner.
The registered manager did not consistently have good oversight of the service. Quality checks took place, but these did not always identify where improvements were needed. The provider's own checks had not identified the shortfalls we found in risk management, medicine administration records and staff training.
Staff were recruited in line with the provider's policy, but improvement was needed to ensure they were sufficiently skilled and knowledgeable to meet people's individual needs. Staff turnover was high and some people felt this had an impact on the consistency of their care. People and relatives told us they received their medicines safely but staff did not always complete medicine administration records accurately. Staff used personal protective equipment effectively and safely. Staff understood how to protect people from abuse.
The registered manager had not always ensured we (CQC) were always informed about incidents we should be legally told about, although they had escalated incidents of concern to other safeguarding authorities.
People were not formally consulted or engaged in the development of the service. However, people and relatives felt the deputy manager was approachable and was committed to meeting people's needs.
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; overall the policies and systems in the service supported this practice.
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 6 July 2022).
Why we inspected
We received concerns in relation to staff response to changes in people's care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Hope Care Rutland on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance at this inspection. You can see what action we have asked the provider to take at the end of this full report.
We have made a recommendation that the provider considers the current MCA legal framework where people experience fluctuating mental capacity.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.