Background to this inspection
Updated
6 August 2022
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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was no registered manager in post. However, a manager had been recruited and was due to start their management position following the inspection.
Notice of inspection
We gave a short period of notice. This was because we needed to be sure the provider would be in the office to support the inspection.
Inspection activity started on 28 June 2022 and ended on 30 June 2022. We visited the office location on 28 June 2022.
What we did before the inspection
We reviewed information we received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all the information to plan our inspection.
During the inspection
We spoke with six people receiving care, four relatives who were involved in their loved ones provision of care, head of care operations, a deputy manager, a quality and compliance manager, three members of staff and one external professional. We reviewed a range of records, including three people’s care records, medication administration records, as well as a variety of records relating to the management of the service.
We also spoke with the nominated individual; the nominated individual is responsible for supervising the management of the service on behalf of the provider.
Updated
6 August 2022
About the service
Right at Home Mid Cheshire is a domiciliary care agency providing personal care to adults in their own homes. The service was supporting 19 people at the time of the inspection.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. Personal Care 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
People received care and support that was tailored around their individual needs and areas of risk. Care records contained up to date and consistent information in relation to the management of risk, although we did find several examples where risk measures needed to be more detailed. This was raised with the provider and was immediately addressed.
Staffing levels were closely monitored; we received feedback to suggest that people received good continuity of care from punctual staff who provided support for the required amount of time. People received care and support from staff who had been appropriately and safely recruited. Pre-employment recruitment checks were carried out and the necessary disclosure and barring service (DBS) checks were conducted. We did note that elements of ‘safer recruitment’ processes needed strengthening.
Infection prevention and control (IPC) policies and procedures were in place. Staff received IPC training, they had access to the relevant PPE and were engaged in a twice weekly COVID-19 testing. A greater level of oversight was required in relation to testing compliance of the staff team.
Safe medication administration processes and systems were in place. Staff received medication training, had their competency levels checked and had access to an up to date medication policy. The provider maintained an effective level of oversight in relation to medicine management.
Safeguarding and incident reporting procedures were complied with. Staff knew the importance of following the safeguarding policy, escalating their concerns and protecting the people they were caring for.
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, staff and relatives confirmed that person-centred, high-quality, compassionate care was delivered. One person told us, “Carers are fantastic, I couldn’t ask for anything better.”
Care records contained personalised information that was tailored around people’s needs, likes and preferences. The provider followed the ‘accessible information standard’; people were effectively supported with any communication support needs that had been identified.
Effective quality assurance measures and systems had been embedded. Such systems helped to monitor, review and improve the provision of care people received. The provider was aware of their regulatory and legal responsibilities; they were familiar with The Care Act and the regulations that needed to be complied with.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 6 August 2020 and this is their first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service which will help inform when we next inspect.