Background to this inspection
Updated
4 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
Prior to the inspection we reviewed information we held about the service. This included notifications received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. We also contacted the local authority who commissioned services from this provider.
During the inspection
During the inspection process we spoke with one person, two relatives, four members of staff, and the provider.
We looked at the care records for three people who used the service and three staff files. We looked at recruitment and training files. We looked at a range of records relating to the running of the service. This included incident and accident records, auditing systems and complaints.
Updated
4 September 2019
About the service
Right Care Health Limited is a community based care provider that provides personal care and support to people in their own homes. At the time of our inspection there were 3 people receiving personal care.
People’s experience of using this service and what we found
People were not always protected from the risk of harm. A lack of clear and detailed risk assessments placed people at risk of receiving unsafe or inappropriate care as staff did not always have sufficient guidance to follow. Medication records were not filled out for medication that was administered and therefore we could not be assured that people had received their medication as prescribed. The provider’s recruitment process was not robust enough to ensure only suitable care staff were recruited. There were enough staff to support people.
People’s needs were not always accurately reflected in their care plans. Staff did not always receive the appropriate training they needed to meet people’s individual health needs. The provider did not always work within the principles of the Mental Capacity Act 2005. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People were supported to eat a healthy diet and care staff knew people’s specific dietary requirements. People were supported by regular staff.
Whilst people told us they were supported by care staff who were kind and caring, the provider’s systems and processes did not support the service to deliver support that was always caring. People's privacy, dignity and independence were respected by staff. People’s equality and diversity needs were respected. People’s religious and cultural beliefs were respected.
Care records did not accurately reflect people’s current support needs. The provider had a complaints policy in place and people knew who to talk to if they had any concerns.
The provider did not have effective governance or auditing systems in place to ensure that people received safe care and treatment. The registered manager was no on site regularly enough to ensure they had sufficient oversight of the service. Governance and oversight systems had failed to ensure risk assessments provided sufficient guidance to staff to ensure people received safe care. There was no robust system in place to ensure risk was appropriately managed. The provider did not have sufficient oversight of training to ensure care staff had specialist training to support people’s individual needs. The provider’s spot checks were ineffective and had not identified areas of concern.
Rating at last inspection
This service was registered with us on 05/08/2014 and this is the first inspection.
Why we inspected
This was a planned comprehensive inspection.
Enforcement
At this inspection, we have identified breaches in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in Regulation 12 (safe care and treatment), Regulation 11 (need for consent) and Regulation 17 (good governance).
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.