The inspection took place on the 1 and 5 October 2015 at the agency office and was completed by contacting people using the service and staff with telephone interviews by the 6 October 2015. The first day was unannounced.
Right at Home (East Lancashire & Ribble Valley) is part of franchise network under the provider Red Rose Homecare Ltd. They agency offers a flexible 24 hour personalised care and support service for people who require additional support to live independently within the community. The agency provides support to people who live in the Ribble Valley District and surrounding areas. Additional services are offered such as domestic support and carer support. At the time of the inspection approximately 40 adults were using the service for personal care and support.
At the time of the inspection there was a registered manager at the service. 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 2008 and associated Regulations about how the service is run.
Throughout this inspection we received very positive feedback from people who used the service, their main carers and a community professional. People expressed satisfaction with the service provided and spoke very highly of the staff who supported them. Their comments included, “Absolutely wonderful. She’s always on time and I trust her with everything. She knows exactly what she is doing. She knows her job.” “They are very kind.” “They are very nice girls.” “They are lovely.”
Relatives told us, “They are exceptional carers who help my husband. He likes to be independent when he can and they support him with this.” And, “Mum is very resistive to help and they have worked very hard. The way they have managed her needs daily is exemplary.” “They certainly tick all the boxes and the standards are high.” “He gets on with them all and looks forward to them coming. I can hear them laughing when I’m doing my own little jobs. Although he is living with dementia, he seems to know them and is happy. So am I.” “I can’t fault them. He (relative) has loads of laughs with them about different things. I have never regretted using this agency.” One relative told us, “I feel cared for too.”
People told us they felt safe in their homes when staff visited. They usually had the same carers who visited and considered this was important to them. Arrangements were in place for staff to gain entry to their home without placing them at risk. People told us staff were respectful towards them and their property. The agency had a code of conduct and practice which staff were familiar with and were expected to follow. This was monitored closely.
Good recruitment procedures were followed to make sure staff were of good character and were suitable for the job. There were processes in place to ensure staff were aware of any risks to people’s safety and wellbeing and the registered manager ensured staff had the knowledge and skills to support people in a safe manner. The agency had processes in place to match staff with people to ensure positive relationships could be developed.
We found the arrangements for managing people’s medicines were safe. Staff had been trained to provide this support. Records and appropriate policies and procedures were in place for the safe administration of medicines.
Care staff we spoke with told us they had training is safeguarding people and had an awareness of the Mental Capacity Act 2005.
People commented on how they 'valued' the service. "It's nice for people to be in their own home. That's where you want to be. I enjoy their visits." "I get all the help I need and want and they will always do that little extra. I usually get the same group of carers visiting.” People told us staff treated them with respect and kindness. Staff worked to care plans that were person centred and sufficiently detailed on how best to meet individual needs.
People told us they felt safe when receiving care and that their care was provided with kindness and consideration. People felt their views and opinions were taken into account and that their care was based on their personal needs and wishes. They were actively involved in the development and review of their care plans.
Staff knew the people they were supporting. Care plans were well written and provided staff with enough information to care for people as they wished. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with these changes. People told us the service was flexible and that any changes needed in their care or times of visits was managed well.
The service had teamed up with a Hospice homecare partnership and also provided a free carer support service for people who care for people with an illness or disability.
The service had developed good links with the community and supported people to take an active part in local events such as a luncheon club at a local church. Coffee mornings and afternoon teas were organised free of charge and people were supported to attend. The agency enlisted the skills of people using the service to help knit sensory bands for people living with dementia. This meant people were supported to be a valued member of a community that showed consideration for others.
People with relatives that lived some distance away or in another country were supported to keep in contact with them. This was by using electronic equipment at the agency to skype their relative or send emails.
People using the service, their relatives and staff spoken with had confidence in the registered manager and felt the agency had clear leadership. There was an open culture within the service that supported people have the confidence to raise any concerns and to be confident any issues they raised would be dealt promptly.
The registered manager had effective systems in place to monitor safety and quality across all aspects of the service which included feedback from people using the service.
The agency was registered with professional bodies such as National Institution for Health and Care Excellence (NICE), Social Care Institute for Excellence( SCIE), Skills for Care, United Kingdom Homecare Association (UKHCA) which is a professional association of home care providers and as a result of this they kept up to date with best practice issues which they cascaded to their staff. Staff performance was monitored well and good practice was acknowledged and rewarded.