Archived: Q Care- Ross on Wye

Updated 17 December 2019

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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the provider 48 hours' notice of our intention to undertake an inspection. This was because the provider delivers a domiciliary care service to people in their own homes, and we needed to be sure that someone would be available in the office.

What we did before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We also sought feedback on the service from the local authority.

During the inspection

We spoke with the registered manager, care coordinator, and one member of care staff. We reviewed a range of records. These included five people's care records, medicines records, three staff recruitment records, accident and incidents records and records relating to the management of the service.

After the inspection

We spoke with four people, four relatives a community healthcare professional about their experiences of the care provided. We also spoke with four care staff. We continued to seek clarification from the registered manager to validate evidence found and reviewed additional documentation they sent to us.

Updated 17 December 2019

About the service

Q Care – Ross on Wye is a domiciliary care agency based in Ross-on-Wye, Herefordshire. The service supports younger or older adults, who may have learning disabilities or autistic spectrum disorder, dementia, mental health care needs, sensory impairments or physical disabilities. At the time of our inspection, there were 42 people using the service.

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

People were at increased risk of harm because of the lack of robust procedures in relation to the management and administration of their medicines. The information recorded on people's medicines records was not always accurate or complete. The risks associated with people’s individual care needs were not always fully assessed to provide staff with clear guidance on keeping people safe. Staff training had not always been kept up-to-date to ensure staff had the skills and knowledge needed to support people safely and effectively. The provider’s quality assurance systems and procedures were not as effective as they needed to be. The records maintained in relation to the assessment and planning of people's care were inconsistent.

Staff understood how to identify and report potential abuse involving people who used the service. People received a consistent and reliable service from the provider. Prospective staff underwent pre-employment checks to confirm they were suitable to provide care in people's homes. Staff took steps to protect people from the risk of infections by, for example, wearing disposable gloves and aprons during people’s personal care. The management team monitored any incidents or accidents involving people who used the service, in order to learn from these.

People's individual needs were assessed with them before their care started. Staff and management recognised the need to promote people's equality and diversity through planning and delivering their care. People had the level of support they needed to prepare meals and drinks. Staff helped them access professional medical advice and treatment if they were unwell. Staff and management worked effectively with community health and social care professionals involved in people's care. Staff understood people’s right to make their own decisions.

Staff treated people with kindness and compassion and had taken the time to get to know people well. People and their relatives were encouraged to express their views about the care provided. Staff treated people with dignity and respect.

People and their relatives were clear how to raise any concerns or complaints about the service. Most people, relatives and staff spoke positively about their relationship and communication with the management team, who they found approachable and ready to help. The management team recognised their responsibility to be open and honest with people and relevant others in the event something went wrong with the care provided.

Rating at last inspection

The last rating for this service was Good (published 20 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified two breaches at this inspection. These relates to the provider's failure to identify and reduce risks to people who use the service, including the safe management of medicines, and the need for more effective quality assurance processes.

You can see what action we have asked the provider to take at the end of this full 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.