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Retons Care and Training Services Ltd Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 July 2018

This announced inspection took place on 7 June 2018. At our previous inspection on 6 April 2017 there was only one person using the service. Therefore, we were not able to rate the service against the characteristics of inadequate, requires improvement, good and outstanding. We did not have enough information about the experiences of a sufficient number of people using the service to give a rating to each of the five questions and therefore could not provide an overall rating for the service.

Retons Care and Training Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to 19 older adults in the London Borough of Bromley. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At this inspection we found improvement was required because risk assessments for falls and medicines were not carried out. Where risks to people were identified, risk management plans did not always have detailed guidance in place for staff on how to manage these risks safely.

People did not have protocols in place for their 'as required' medicines (PRN). The provider did not have effective processes in place to monitor the quality of the service as they had not identified the issues we found at this inspection. Following the inspection the provider submitted documentation to show us that they had taken action to address our concerns.

The service had a registered manager 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.

There were appropriate safeguarding and whistleblowing procedures in place and staff understood how to safeguard people and how to raise any concerns. There was a system to log accidents and incidents. People were protected from the risk of infection as staff had been trained in infection control. Appropriate recruitment checks took place before staff started work. There were enough staff deployed to meet people's care and support needs.

Staff completed an induction when they started work and they had completed a mandatory programme of training that was relevant to peoples’ needs. Staff were supported through regular supervisions and appraisals. Staff obtained people’s consent before assisting them with their care needs. People's needs were assessed to ensure the service could meet these needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were also supported to have a balanced diet and had access to a range of healthcare professionals when required to maintain good health.

People told us staff were caring. Staff respected people’s privacy and dignity, and encouraged people to be as independent as possible. People were involved in making decisions about their daily care and support requirements and were provided with information about the service in the form of a service user guide. Staff had received training on equality and diversity. The registered manager said that the service would support people according to their diverse needs where required.

People were involved in planning their care and support needs. People were aware of the provider’s complaints procedure and knew how to make a complaint. Complaints were managed and dealt with in a timely manner. When appropriate, people’s end of life care wishes would be recorded in care plans.

The provider carried out regular spot and competency checks to make sure people were being support

Inspection areas

Safe

Requires improvement

Updated 20 July 2018

The service was not consistently safe.

Risk assessments for falls and medicines were not carried out.

Risk management plans did not always have detailed guidance in place for staff on how to manage these risks safely.

People did not have PRN protocols in place for their 'as required' medicines.

There was a system in place to record accidents and incidents.

People were protected from the risk of infection.

There were appropriate safeguarding and whistleblowing procedures in place to protect people.

The service had enough staff deployed. Appropriate recruitment checks took place before staff started work.

Effective

Good

Updated 20 July 2018

The service was effective.

People's needs were assessed prior to them joining the service to ensure the service could meet people's care needs.

Staff received the appropriate training and were supported through regular supervisions and appraisals.

Staff asked people for their consent before they provided care. Staff were aware of the Mental Capacity Act 2005(MCA) and acted according to this legislation.

People were supported to have a balanced diet if required.

People had access to a range of healthcare professionals when required to maintain good health.

Caring

Good

Updated 20 July 2018

The service was caring.

People and their relatives said the staff were caring.

People and their relatives were involved in decisions about their daily care needs.

People's privacy and dignity was respected and staff encouraged people to be as independent as possible.

Staff had received training on equality and diversity and said they would support people according to their individual diverse needs.

People were provided with information about the service in the form of a service user guide.

Responsive

Good

Updated 20 July 2018

The service was responsive

People and their relatives were involved in planning their care needs.

People were aware of the provider’s complaints procedure, and complaints were managed appropriately and in a timely manner.

Where appropriate, people had their end of life care wishes recorded in their care plans.

Well-led

Requires improvement

Updated 20 July 2018

The service was not consistently well-led.

Quality assurance processes were not effective as they did not identify the issues we found at this inspection in relation to risk management plans and medicines administration.

There was a registered manager in post.

Regular staff meetings took place.

The provider took into account the views of people using the service and staff to help drive improvements if necessary.

Staff were complimentary about the registered manager was supportive and approachable.

The service worked closely in partnership with the local authority.