Redspot Care Limited

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.

Redspot Care Limited is a domiciliary care agency that provides personal care to people 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. They were providing personal care to 196 people at the time of the inspection.

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

Right Support

Call planning and monitoring at the service was poor. People and relatives confirmed what our analysis found; lateness and missed calls were problematic. We raised a safeguarding alert with a local authority due to concerns shared by a relative with regards to missed calls. Following our feedback to the provider, they took steps to rectify this.

People’s needs were assessed so the service was able to understand and meet those needs. Staff worked with health and social care professionals to provide people with effective care. People were supported to eat and drink where required.

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’s consent was sought when care was provided, and they were given appropriate choices by staff.

Right Care

The service lacked adequate systems to ensure people received good care regularly. People had mixed views on how the service engaged with them.

People and relatives told us they were treated well by staff. People’s equality and diversity characteristics were respected as was their privacy and dignity.

There were systems in place to safeguard people from abuse. Recruitment practices were robust. Staff were employed with people’s safety in mind. Infection prevention and control measures were followed by staff.

People’s communication needs and preferences were recorded in care plans. People and relatives were able to complain, and the service responded to complaints appropriately. The service worked with people who were at the end of their lives.

Right Culture

It wasn’t always clear if lessons were learned when things went wrong. We found the provider did not always follow their policy when incidents and accidents occurred. Risks to people were assessed, we found care plans and risk assessments were not always reviewed in a timely fashion.

Staff received training to support them in their roles, though we were told a training matrix used by the service had not been updated recently. People and relatives were not always able to express their views about the care provided; we found evidence indicating care plan and risk assessments reviews were not completed as regularly as they should have been.

Staff were supported through 1 to 1 meetings with management and received inductions when they started working for the provider.

The registered manager and staff were clear about their roles and the provider understood and fulfilled their regulatory requirements. The service worked in partnership with other agencies to support people with their needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 29 October 2020). At our last inspection we recommended that the provider follow guidance about sending CQC notifications. At this inspection we found the provider had made improvements in this regard.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to staffing and good governance 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.

Redspot Care Limited is a domiciliary care agency and is based in the London Borough of Redbridge. The service provides personal care to adults 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, the service provided personal care to approximately 180 people.

People’s experience of using this service and what we found:

The service was safe. There was a safeguarding procedure for staff to follow. Staff understood how to identify and report safeguarding concerns to protect people from abuse. People had risk assessments in place for staff to manage their care needs and keep them safe.

There was a procedure for reporting accidents and incidents and learning lessons to prevent reoccurrence. However, the registered manager did not always notify the Care Quality Commission of incidents or safeguarding concerns in the service in a timely manner. Notifications should be sent to us without delay and we have made a recommendation about this.

Staff followed safe infection control procedures. They used protective equipment to help prevent themselves and people from catching and spreading infections. There were enough staff to provide care to people across four different boroughs and they were recruited safely.

People, relatives and staff were positive about the management of the service. There was a system for people and relatives to provide their feedback about the quality of the service. Team meetings with staff were held with the management team to discuss important topics and go through concerns.

The provider was working towards completing a service action plan which identified areas for improvement to help drive continuous improvements in the service. The provider worked in partnership with commissioners and health professionals to ensure people remained in good health.

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 the service was Good, published on 2 October 2018.

Why we inspected

We received concerns in relation to people not being protected from the risk of abuse and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led

only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Redspot Care Limited is based in the London Borough of Redbridge. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using Redspot Care receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection, approximately 267 people were using the service, who received personal care. The provider employed approximately 112 care staff, who visited people living in three local boroughs.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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.

People had their individual risks assessed and staff were aware of how to manage these risks. The provider had sufficient numbers of staff available to provide care and support to people. The provider used an online call system to ensure staff were monitored when providing care to people in the community and people received care at the assessed times.

Staff had been recruited following background checks, to ensure staff were safe to work with people. New staff received an induction, training and shadowed experienced staff to enable them to carry out their roles effectively.

When required, staff prompted people to take their medicines and recorded this. They had received training on how to do this and their competency was assessed. The registered manager sought professional advice on completing medicine records and had recently implemented changes to ensure records were robust.

Accident and incident records showed the provider took appropriate action following incidents. Systems were in place to analyse patterns and trends to ensure lessons were learnt and repeated incidents were minimised.

The provider was compliant with the principles of the Mental Capacity Act 2005 (MCA) Staff had received supervision and training to ensure the service they provided to people was effective.

Staff told us that they received support and guidance from the registered manager and other senior staff. They received regular supervision and could approach the management team with any concerns they had.

People were listened to by staff and were involved in their care and support planning. People told us they were treated with dignity and respect when personal care was provided to them. People were supported to have their nutritional and hydration requirements met by staff.

People's care and support needs were assessed and reviewed when required. Care plans were person centred. They provided staff with sufficient information about each person’s individual preferences and how staff should meet these in order to obtain positive outcomes for each person.

The provider worked with health professionals if there were concerns about people's health. People were registered with health care professionals, such as GPs and staff contacted them in emergencies.

Complaints about the service were responded to appropriately and within the provider’s timescales as set out in their complaints procedures.

The management team carried out regular monitoring checks on staff providing care in people’s homes. This ensured they followed the correct procedures and people received safe care. Feedback was received from people and relatives to check they were satisfied with the service. The registered manager was committed to developing and improving the service.