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Archived: Care Rangers Limited Requires improvement

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Inspection report

Date of Inspection: 13, 16 December 2013
Date of Publication: 10 January 2014
Inspection Report published 10 January 2014 PDF


Inspection carried out on 13, 16 December 2013

During a routine inspection

We spoke with five care workers who were able to tell us how they respected people and helped ensure dignity for people who used the service was promoted and maintained. One care worker explained that they asked people how they preferred to be supported when they received personal care. They also told us that they communicated in a compassionate and sensitive manner. One person who used the service said: �My carers really understand my little ways. They are so thoughtful and attentive� This meant that people�s privacy, dignity and independence were respected.

Where it had been documented that people lacked capacity to make certain decisions, we did not see evidence to demonstrate that best interest meetings had taken place. Care workers were not able to describe the principles of the Mental Capacity Act (MCA) 2005 and were not knowledgeable about the questions to ask when assessing people�s capacity to consent to care and treatment. There was no evidence that staff received training or were given information about the Mental Capacity Act (MCA) 2005, which meant that staff may not be aware of their responsibilities in caring for people who lack capacity.

We asked one care worker how they ensured the care and welfare of people they were caring for and if the care records in people�s home enabled them to provide person centred care, they told us: �I am proud of the care I provide, the service user must always come first. We looked at 10 care plans. Each contained an initial assessment of the person�s needs and background information relevant to their care. Five of the care plans we looked at contained a copy of the local authority�s plan of care that detailed the person�s needs. However we found that the providers own care plans lacked detail and did not always provide sufficient information to meet people�s needs.

People's medicines support was not always adequately assessed to support the way in which it was delivered. Care plans stated that people should only be prompted to take their medicines; however, the provider had not carried out assessments of people's medicines arrangements in all cases. Care plans did not detail the requirements of how people needed to be prompted, or when they needed prescribed creams or eye drops to be applied.

In the eight care worker files we reviewed we could find no evidence to support that care workers had received any refresher training in safeguarding after their initial induction training. There was no evidence that a training plan was in place to ensure that all care workers received ongoing training for their professional development.

We looked at 14 customer survey questionnaires that had been completed during November / December 2013. Comments from people who used the service were generally very positive, for example �I cannot fault the care I receive it is top notch� �Very nice girls. Always help when asked� and: �My carer is really nice and friendly. I don�t know what I would do without them�.

We could not establish how often care workers were visiting people or for how long the duration of the visit was meant to be. Whist we could establish some people�s identified needs, we did find people�s care folders in the home to be dis-organised. Information was not filed in sequence and this made the care plan difficult to follow.