About the service Royalcare Thanet is a domiciliary care agency which provides care and support to people living in their own homes. At the time of our inspection there were 16 older people using the service. Not everyone who used the service received personal care. The Care Quality Commission (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 were not supported by staff who had been consistently safely recruited. The provider could not be assured they had obtained full employment histories. References, when new staff had previously worked in social care had not always been obtained to ensure they were of good character.
COVID-19 risk assessments for people and staff were not robust. The registered manager took immediate action to address this during the inspection.
Checks and audits were not consistently robust. When the previous registered manager had left the service, there was no system in place to review their emails to ensure there was no outstanding work to be followed up.
People told us they were supported by regular staff, who arrived on time and stayed the right amount of time.
People told us they felt safe with staff from Royalcare Thanet supporting them. They knew how to contact office staff if they had any concerns. Staff understood how to keep people safe and knew they could report concerns to the registered manager. They felt the right action would be taken.
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 physical, mental health, social and emotional needs were assessed and regularly reviewed. People and their relatives were involved in their care and support. Care plans provided staff with detailed information about how people preferred to be supported and contained information about their life history, family and any goals they wanted to achieve.
People and their relatives said staff were patient, caring and kind. They knew how to complain and had no complaints about the service they received. They felt the service was well-managed and told us the communication was good.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. At the time of the inspection the service was not supporting anyone with a learning disability.
Right support: Model of care and setting maximises people’s choice, control and Independence
People were supported to be as independent as possible and make their own decisions. People were able to discuss their personal goals and talk to staff about how these could be achieved. People’s communication needs were assessed and there were processes in place to provide information in a way people could understand. For example, using picture cards or larger print.
Right care: Care is person-centred and promotes people’s dignity, privacy and human rights
People received care and support, planned with them and their relatives, which concentrated on their individual needs and preferences. A holistic approach was used to consider people’s physical, emotional, psychological and social care needs. Privacy and dignity were respected, and people’s human rights were protected.
Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
The provider’s values of ‘Care, Attentiveness, Respect and dignity and Empowerment’ were shared by the staff team. People and their relatives spoke positively about the leadership.
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 23 December 2020 and this is the first inspection.
Why we inspected
This was a planned inspection based on our inspection programme.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to recruitment 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.