Archived: Regents Care Services

Following the last inspection on 8 and 9 September 2016, we asked the registered provider to take action to make improvements relating to their quality assurance arrangements, and this action has been completed.

This inspection was undertaken on 16 and 23 November 2017 and 11 December 2017. At the time of the inspection five people were receiving a domiciliary care service from Regents Care Services.

A registered manager was in post. 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.

Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were followed to ensure the right staff were employed. People were protected by the providers arrangements for the prevention and control of infection. Arrangements were in place for learning and when things go wrong.

Staff received an induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met. People received appropriate healthcare support as and when needed and staff knew what to do to summon assistance. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have choice and control of their lives.

People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Social activities were available for people to enjoy and experience both ‘in house’ and within the local community. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns.

Suitable arrangements were in place to assess and monitor the quality of the service provided. There was a positive culture within the service that was person-centred, open and inclusive. The service sought people’s and others views about the quality of the service provided.

Further information is in the detailed findings below.

Regents Care Services is registered to provide personal care to people who live in their own home. There were seven people receiving a service at the time of our inspection.

A registered manager was in post. 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. The registered manager was on leave at the time of our inspection and we were assisted by the care coordinator.

Established systems were in not place to monitor and assess the quality of the service people received. Processes were not in place to manage any risks in relation to the running of the service. Policies and procedures were not linked to current guidance and legislation. While people had some opportunities to say how they felt about the service provided, the information was not evaluated to show that people were listened to and to see if any improvements were needed.

Work was needed to improve records relating to people’s individual risk and care records and medicines. Systems to ensure robust staff recruitment and to ensure staff were provided with timely training and supervision were not consistently organised. Staff appraisal was not well implemented. Actions had commenced to develop the staff induction training programme.

Care records included people’s preferences and individual needs so that staff had information on how to give people the support that they needed. People, and their relatives where appropriate, were fully involved in the planning and delivery of the support provided. People confirmed they received the care they required and their individual preferences and practices were responded to positively.

People’s dignity and privacy was respected and people found the staff to be reliable, friendly and caring. Staff had positive and caring relationships with the people they supported. People had choices of food and drinks that supported their nutritional or health care needs and their personal preferences.

People knew the registered manager and found them to be approachable.

In February 2014, at our request, the provider sent us an action plan telling us how they were going to improve. They told us they had updated the medication policy and that staff would be receiving regular up dated training.

In July 2014 we completed a review of the provider's compliance with this standard. We requested that the provider send documentation to support their compliance. When we received this documentation, which included a copy of the medication policy and staff training plan. We completed a review of compliance and found that the provider was now compliant with this standard.

One relative said, 'I can tell that [my relative] is content when they are with staff. Staff watch for signs in [my relative's] behaviour. [My relative] would not do something they did not want to do and staff would not attempt to force them.'

We saw examples of detailed behavioural support guidance contained within each care plan. This guidance gave staff clear information about triggers, signs of escalation and redirection strategies to support the person to manage their behaviour. Staff we spoke with had a good understanding of this guidance.

Care plans for some people did not contain sufficient guidance in relation to the support they required with medicines. The provider's medication policy did not cover the use of as required (PRN) or short term courses of medicine. The policy did not give sufficient guidance in relation to the covert administration of medicines. This meant that people were not protected from the risks associated with the unsafe use and administration of medicines.

We looked at the personnel records for five staff. There were effective recruitment and selection processes in place.

The provider had systems in place to seek the views of people who used the service or their relatives.

One relative said, 'The service is very good, the staff are always willing to accommodate us and I am very happy with it.' Another relative said, 'The service is fine, it is a good service and I am very happy with it.'

Relatives told us that they were happy with the support plans and the quality of the service. They said that they met their relative's needs.

People told us that they felt their relative was safe when using the service. We found that staff had been trained and had received regular updates in their training. Staff told us that they felt well supported.