Archived: Rest Assured We Care Limited

Updated 4 March 2017

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 inspection took place on 17 January 2017 and was conducted by one inspector and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. Our expert by experience conducted telephone interviews with people who used the service and their relatives on the day of the inspection.

Before the inspection, we reviewed all the information we held about the provider. This included information sent to us by the provider in the form of notifications and safeguarding adult referrals made to the local authority. A notification is information about important events which the provider is required to tell us about by law. We contacted the local authority quality assurance and safeguarding team to ask them for their views on the service and if they had any concerns. On this occasion we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with six people, three relatives, five staff members, the manager and the nominated individual.

We reviewed a variety of documents which included six people’s support plans, risk assessments, some staff recruitment records and quality assurance records. We also looked at a range of the provider’s policy documents. We asked the manager to send us some additional information following our visit, which they did.

Updated 4 March 2017

Rest Assured We Care Limited is a domiciliary care agency that only provided live in care to people in their homes. The staff provided help people with personal care where required. Staff also provide support to people for domestic tasks and companionship. They cover London, Surrey, Berkshire, Hampshire, Sussex, and Dorset. The registered office is in Surrey. At the time of inspection, there were 36 people receiving a service, with 23 people receiving support with their personal care (the regulated activity).

The service was run by a manager who was not yet registered with CQC, although an interview date is pending. The manager had been with the service for two months. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

People’s human rights were not always protected as the manager had not ensured that the requirements of the Mental Capacity Act were followed. For people that lacked capacity to make decisions there were mental capacity assessments, however it was not in line with the MCA code of practise. Best interest decisions did not occur.

People told us that staff had the right skills and knowledge to support them. However, the provider did not provide much opportunity for training and staff to renew their skills and learn new ones. Staff received regular supervision. The manager and provider told us they are in the process of reviewing the training and competency assessments for staff.

The service was not always well led. There were some systems in place to monitor, review and improve the quality of care for people; however they were not robust or regular. Communication to people and staff could be improved.

People told us that they felt safe. Despite this, risks to people were not always managed. Some risks to people had been identified but there was no management plan in place, although no harm had come to people. Some people had risk management plans in place to minimise the risk of harm. We have made a recommendation about this in the main body of our report.

The manager lacked oversight of some incidents and accidents. There were no follow up or actions taken for some accidents, which meant that steps were not put in place to reduce the risks of them occurring again.

People’s medicines were administered and stored safely. People were supported to maintain their health and wellbeing. People were supported to eat healthy balanced meals.

People were protected from harm as staff were clear about their responsibilities in relation to safeguarding. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

There were sufficient staff to keep people safe. There were robust recruitment practises in place to ensure that staff were safe to work with vulnerable people.

People would receive a service should an emergency arise. We saw that the service had an emergency protocol in place which advised the management and staff what to do if events stop the service

Positive and caring relationships had been established. Staff new people needs, likes and preferences. People and their relatives were involved in planning peoples care. People’s choices and views were respected by staff. People’s privacy and dignity was respected.

People received a responsive service. People were supported to maintain their independence. People were supported to continue with their interests and activities.

People told us that they felt listened to. There was a complaints procedure in place, complaints had been dealt with in line with the company policy.