Archived: English Rose Care- Wellingborough

Updated 28 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This first comprehensive inspection of the service, carried out by one inspector, was announced and took place over three days, 20 April, 26 April and 3 May 2018. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to arrange calls to people using the service and staff.

We reviewed the information we held about the service and notifications we had been sent. Notifications are changes, events or incidents that providers must tell us about. We also received feedback from the commissioners of the service and a member of their quality monitoring team.

We initially visited the agency office in Wellingborough on the 20 April 2018 to look at care and management records. With their prior agreement we visited three people at home to find out about their experience of using the service. We also spoke with five people who had agreed to be contacted by telephone. During the inspection we met and spoke with the registered manager, the ‘branch manager’ who acts as their deputy, six care staff including a team leader, and two office based business support staff.

We looked at the care records belonging to six people who used the service. We also looked at other information relation to the day-to-day management of the service. This included four staff recruitment and training records. We also looked at policies and procedures, records relating to safeguarding, complaints and quality assurance monitoring records.

Updated 28 July 2018

This was the first comprehensive inspection of English Rose at their Wellingborough location since the regulated activity of ‘personal care’ was registered with the Care Quality Commission (CQC).

English Rose provides a domiciliary care support service providing the regulated activity of ‘personal care’ to people living within their own homes in the community. When we inspected the service predominantly covered the Wellingborough and Kettering areas of Northamptonshire, although several people living in the Bedford area received a service. The service provided included support for people with end of life personal care support needs. There were 19 people receiving support at home when we inspected.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social care Act 2008 and associated regulations about how the service is run.

The registered manager had not always maintained adequate oversight of the reliability of the service. Some people had experienced late or missed calls or had not always been informed if their care worker was going to be late. Although lessons had been learned and people felt they could now rely on the service the improvements were relatively recent and need to be seen to be sustained.

Some records relating to staff recruitment and the day-to-day running of the service had not always been consistently completed with the necessary details, with dates sometimes left unrecorded and the person completing the record left unidentified. Again, and following a recent internal audit carried out a senior staff member, these shortfalls had already been identified. The improvements made need to be seen to be sustained.

Although staff had received the basic training they needed to do their job training for staff with little or no experience could be further enhanced. It is acknowledged that further training opportunities were being organised when we inspected.

People's consent was sought before any care was provided and the requirements of the Mental Capacity Act 2005 were met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in place at the service supported this practice.

Staffing levels were sufficient to meet people's current needs, although recruiting sufficient staff able to work in the Bedford area had initially proved difficult. There had been previous occasions when providing ‘back-up’ staff to cover for sickness or holidays had compromised the reliability of service, with staff arriving late or relatives having to be contacted to establish if they were able to provide cover because of staff being unavailable. This had been recently resolved when we inspected but the availability of ‘back up’ staff needs to be seen to be sustained in conjunction with the other recent improvements to the service.

The staff recruitment procedures ensured that appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.

People’s needs had been assessed prior their service being agreed. There were plans of care in place that been developed to guide staff in providing care in partnership with people who used the service. Their care records contained risk assessments and risk management plans to mitigate the risks to people. These plans provided staff with guidance and information they needed on how to minimise the identified risks.

Staff treated people with kindness, dignity and respect. People were happy with the way that staff provided their care and support and they said they were encouraged to make decisions about how they wanted their care to be provided.

Staff had a good understanding of what safeguarding meant and the procedures for reporting abuse. The staff we spoke with were confident that any concerns they raised would be followed up appropriately by the registered manager or other senior staff.

Arrangements were in place for the service to reflect and learn from complaints and incidents to improve safety across the service.

The provider worked in partnership with other agencies and commissioners to ensure that where improvements were needed action was taken. Communication was open and honest, and any improvements identified were worked upon as required.