Ram Personnel Healthcare

Updated 23 June 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried by 1 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 10 May 2023 and ended on 17 May 2023. We visited the location’s office/service on 10 May 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 29 November 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

People were unable to speak to us, however we spoke with 2 people’s relatives who used the service about their experience of the care provided. We spoke with 3 members of staff, including the registered manager (who was also the nominated individual), and two care workers.

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 2 people's care records and medication records. We looked at electronic staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 23 June 2023

About the service

Ram Personnel Healthcare is a domiciliary care service providing the regulated activity of personal care. At the time of our inspection there were 6 people using the service, 2 people were receiving the regulated activity of personal care.

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 received care from staff who were kind and caring. However, aspects of the providers governance systems needed to improve to ensure people received safe care by staff who had been safely recruited.

The management of people’s risks and personalised care were known by staff. However this information hadn’t always been comprehensively recorded. People received their medicines as prescribed, however medicines care plans were not always complete or accurate. This meant staff did not always have the information to support people safely with their care, risks and medicines.

Safe recruitment practices of new staff had not always been followed.

Although we found shortfalls in the providers quality monitoring and governance systems, the registered manager had good oversight of the service. Relatives felt confident in the management of the service and that any concerns would be acted on.

People were well cared for by staff who treated them with respect and dignity. People’s relatives said they felt safe and knew the staff coming into their homes. There were enough staff to meet people's needs and who knew them well. Staff had formed working relationships with health care professionals and families which helped promote consistency in the delivery of people’s 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.

Staff had completed training and shadowed staff to understand people’s specific care needs. However, the registered manager was developing improved systems to train and monitor the skills of staff.

The registered manager was passionate about delivering high quality and personalised care. They used feedback from people to drive improvements across the service and to ensure people’s needs were being fully met.

Systems were in place to monitor the infection control practices, complaints, accidents and incidents.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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 28 February 2022, this is the first inspection.

Why we inspected

This service had not been inspected since their registration; therefore, this inspection was also carried out to gain assurances about the quality of care and systems used to monitor and manage the service.

Enforcement and Recommendations

We have identified breaches in relation to the management of people’s risks and medicines and also recruitment and quality monitoring at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.