We carried out a review of the data available to us about Ripon and District Homecare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ripon and District Homecare, you can give feedback on this service.
People’s experience of using this service: All the people and relatives we spoke with felt staff provided care in a dignified and respectful way. Positive relationships had been fostered between staff and the people they cared for which meant they understood people’s preferences, but also that they enjoyed and valued each other’s company.
People told us their feelings of wellbeing benefited from the person centred approach staff had to their work. People were able to describe the little things staff did which meant a lot to them and made them feel valued and cared for. The service was responsive to people’s changing needs and people felt involved and listened to. The service paid attention to people’s social needs and worked to overcome isolation for people.
The provider had challenged themselves since the last inspection and improved the care plan systems, medicines management and their approach to monitoring quality and safety. They told us they felt more confident and understood better what was happening in the service because of this.
Staff felt supported and felt more confident now they had better systems to support them to fulfil their role. All the staff understood the providers vision to ensure people were treated as individuals and worked to ensure they delivered person centred care for people. 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.
The provider involved people, relatives and staff in the management of the service and used feedback to determine how they could continuously improve. Everyone we spoke with felt confident to raise concerns to the provider and understood they would be listened to and acted upon.
For more details, please see the full report below which is also on the CQC website at www.cqc.org.uk.
Rating at last inspection: At the last inspection the service was rated requires improvement (published 19 January 2018).
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
At our last inspection in September 2015 the provider was meeting all legal requirements and the service was rated Good.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people and younger adults some of whom may have a learning disability and or Autism spectrum disorder, mental health concerns, physical disability or sensory impairment. People may also be living with dementia. 26 people were using the service when we inspected.
The service had two registered managers who shared responsibility for the running of the service and who were also the business partners who own the service and were therefore the provider. 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 report we will refer to the registered managers as the provider.
The provider had failed to keep themselves up to date regarding changes to good practice and their responsibilities around meeting the regulations. This meant robust systems were not in place in areas such as medicines support, assessment of risks to people who used the service, appropriate practical training for staff and records relating to the recruitment of staff and accident records. The quality assurance system in place had not therefore identified these issues which meant it was not effective.
The provider responded quickly during the inspection to design and implement systems which were appropriate. The provider told us they would join forums available to ensure they remained up to date in the future.
There were enough staff employed to provide support and ensure people’s needs were met. People told us the service was flexible and reliable. Staff told us they felt supported through regular supervision and appraisal. Also that they had received training which they felt provided the knowledge they needed to fulfil their role to a high standard. Staff were aware of the different types of abuse and what would constitute poor practice. The provider was aware of how to report concerns if they were raised.
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.
Staff knew people’s preferences, likes and dislikes and people told us they felt well cared for by the staff. The individual information staff knew about people and their needs was not always recorded so that all of the team were aware. The provider took immediate steps to ensure records improved.
People and relatives told us staff treated them with dignity and respect. They told us staff had developed positive relationships with them which meant they felt safe and well supported. Staff encouraged and supported people to maintain links with their local community and to access social activities where they wanted to. Staff were responsive to people’s needs.
Where needed people were provided with their choice of food and drinks which helped to ensure their nutritional needs were met. Staff worked with other healthcare professionals to ensure people’s health needs were met.
The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident staff would respond and take action to support them. We saw people were regularly asked their views about the service they received and the provider responded to make improvements where needed.
A breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was found during this inspection. This related to good governance. You can see what action we told the provider to take at the end of this report.
The inspection was carried out on 15 September 2015. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available.
At our last inspection on 19 September 2013 the provider was meeting the regulations that were assessed.
.Ripon and District Homecare are registered to provide personal care to people in their own homes. The agency's office is situated in the centre of Ripon. The agency is registered as a partnership; there are two people registered for this partnership; one of whom is also the registered manager. The other person works alongside the registered manager in a day to day management role 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 feedback we received from people who used the service and their relatives was very positive. We received no negative comments. People told us they had confidence in the staff and they felt safe in the way staff supported them.
People received care and support in their own homes according to their individual needs. People told us the service was flexible and wherever possible would accommodate any changes to people’s requirements. Risks to people’s safety and welfare had been assessed and information about how to support them to manage risks were recorded in people's care plan.
Appropriate checks were made as part of the service’s recruitment process. These checks were undertaken to make sure staff were suitable to work with people who may be vulnerable. The service provided a training programme for staff to ensure they had the knowledge and skills to support people. This included a comprehensive induction and training at the beginning of their employment, and all mandatory health and safety training. We saw systems were in place to provide staff support. Staff participated in staff meetings, and one to one supervision meetings with their supervisor and completed an annual appraisal. The agency had a whistleblowing policy, which was available to staff. Staff told us they would feel confident using it and that the appropriate action would be taken.
Where people needed assistance taking their medication this was administered in a timely way by staff who had been trained to carry out this role.
Staff liaised with healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing. People were provided with care and support according to their assessed need.
People who used the service told us they gave consent to their plan of care and were involved in making decisions around how their support was provided. People’s care plans were reviewed to meet their changing needs. Staff told us they felt well informed about people’s needs and how to meet them.
Policies and procedures were in place covering the requirements of the Mental Capacity Act 2005 (MCA), which aims to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment. Staff had received training in this subject.
People described staff from the agency as kind and considerate and people told us that they were treated with dignity and respect. People told us they were involved in discussions and reviews of their care packages. People told us that they received a person centred service. They said they were always introduced to staff before they provided care on their own. Staff we spoke with told us how much they enjoyed working for the service and were committed to providing an excellent service for people.
People said they were confident in raising concerns. Each person was given a copy of the agency’s complaints procedures.
The provider had systems in place to enable people to share their opinion of the service provided and to check staff were performing their role satisfactorily.