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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looked at the overall quality of the service.
The inspection was announced in order to ensure that the people we needed to talk to were available, 48 hours notice was given before the inspection. Rank Lodge, also known as Home Care Finder is a community care agency which provides personal care, respite care and a domestic service to adults and older people between the ages of 18 – 65 years. The agency operates in north and north west Hampshire and east Wiltshire. At the time of the inspection, the service was providing care and support to 58 people who needed support with a range of tasks such as personal care, meal preparation and respite care.
Rank Lodge had not had a registered manager in place since May 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The provider told us that a recruitment process was underway to appoint a new manager. In the interim, the provider had appointed a business and a care consultant to support the existing management team in the day to day running and on-going development of the service.
At our last inspection in October 2013 we found that the service was not complying with some aspects of the Health and Social Care Act 2008. This was because the Provider had not assessed the mental capacity of people to ensure they were able to give valid consent to their care and support. The provider sent us an action plan telling us that they would be compliant by May 2014. At this inspection we judged that the service had made the required improvements. Staff were considering whether people had mental capacity to agree to their care and support plans. We found therefore that the service had addressed the previous concerns that we had.
People told us they felt safe when being supported by care workers. Staff had a good understanding of how to identify and act on allegation of abuse to help keep people safe. Staff were aware of the importance of disclosing concerns about poor practice or abuse and understood about the organisation’s whistleblowing policy.
Safe recruitment practices and appropriate pre-employment checks were completed before new staff started at the service.
There were sufficient numbers of suitably qualified staff so people received their care from a team of care workers who were familiar with their needs.
People told us care workers provided them with the support they needed. We observed care and support being delivered in line with people’s care plans by care workers who were familiar with the needs and preferences. One person told us, "They are all used to my quirky habits, they understand what they need to do."
Staff were supported to develop their skills and knowledge by providing a programme of induction and training which helped them to carry out their roles and responsibilities effectively. However some staff had not received all of the training relevant to their role.
People were asked what assistance they needed with food and drinks when the service assessed their needs. Care workers were aware of how to identify whether a person might not be eating and drinking in sufficient quantities to maintain their wellbeing.
Staff were kind and respectful to people. Overall people we spoke with were positive about their care and the support they received from staff. One person told us the care workers were, "Wonderful, absolutely super." Another person described the care workers as "Extremely thoughtful and kind." A third person said, "I like my carers very much, they are nice in every way."
People’s assessments and care plans were reviewed on a regular basis and updated as their needs changed. This helped to ensure that people received the care and support they needed. Staff told us how they read people’s support plans and used the information in them provide personalised care.
People told us they knew how to make a complaint. Information about the complaints procedure was included in the service user guide which we found in the homes of each of the people we visited. People were confident that any complaints would be taken seriously and action would be taken by the service.
There was a management team in place which helped to ensure that the service was well led in the absence of a registered manager. There were some systems to monitor and improve the quality of the service. Further measures, such as weekly reports and a range of audits, were being developed to ensure the provider had greater oversight of events which might affect the quality and safety of the service.