Roses Homecare Ltd

Roses Homecare Ltd is a domiciliary service providing personal care to 82 people at the time of the inspection.

Not everyone using Roses Homecare Ltd receives regulated activity; 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 consider any wider social care provided.

People’s experience of using this service and what we found

We have made recommendations about ensuring effective systems for monitoring missed care visits and ensuring effective systems for checking staff character and employment history. Please see the action we have told the provider to take at the end of this report.

One person said they had experienced some missed care visits. However, most people said they felt safe because the same staff support them and staff were on time, did not rush them and managed risks. Staff supported people with their medicines safely.

People said that staff had the skills and experience to support them as per their care plan. Staff asked people’s consent before starting work. Where required, staff supported people to access various healthcare services. Staff supported people who needed assistance with drinks and meals.

People thought staff were caring, friendly and kind and treated them well. People were involved in their care planning and reviews to decide how they wanted to be supported and what care they needed. People told us staff were gentle and supported their privacy while encouraging them to do what they could for themselves. People told us they liked that staff would sit and talk to them and listen.

People and their relatives felt confident to raise a complaint if needed. Most people did not have any complaints, and those that did were satisfied they were resolved. People told us staff knew their likes and dislikes well and respected them.

People found the staff and management team approachable and most people gave positive feedback. One person told us, “The service is run well as the proprietor is very caring and knows the principle of caring for elderly people.” Other people told us they had regular contact with the registered manager and office staff who asked their views of the care.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated Good (published 22 July 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will speak with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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

Roses Homecare Ltd provides personal care to people who live in their own homes in order for them to maintain their independence.

At the time of our inspection the provider confirmed they were providing personal care to 50 people.

There was 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Staffing levels were adequate to meet people's current needs.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles.

People told us that their medicines were administered safely and on time.

Staff were well supported by the registered manager and senior team, and had regular one to one

supervisions.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this, and people were supported to access health appointments when necessary.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required. The people we spoke with knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed

Below is a summary of what we found. The summary is based on discussions with people using the service, the staff supporting them and from looking at records.

We found that the home was meeting all areas.

If you wish to see the evidence supporting our summary please read the full report.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found.

Is the service safe?

The provider had allocated the correct number of staff to assist with the care and support of people who used the service. Staff were aware of the needs that people had and followed the information available with in the care plans. Staff were well supported, observations and supervisions were carried out regularly to ensure that staff were providing a good level of care to people. Staff we spoke with told us that the training they received was 'good' and the provider was able to evidence the staff training programme which had been created for 2014 to update any training that was needed by staff.

Is the service effective?

People were supported by kind and caring staff. Staff we spoke with told us that they enjoyed the job and that they were generally assigned to the same person so knew their needs well and were able to develop a relationship with them. One person told us that the care staff 'took their time' and were 'gentle' when providing them with personal care. We were told that the staff 'always talk you through' what they were doing and made them 'feel comfortable'.

Is the service caring?

When we spoke with people using the service we were told that the staff 'look after us well'. One person said that they were 'unable to put it in words' how caring the staff were. People we spoke with had no complaints about the service and said that care staff were generally on time, and if they were running late then they would be informed. We saw from the care documents that staff were advised in detail on how to support and care for people.,

Is the service responsive?

Care plans were regularly reviewed and updated according to the person's needs. Each care document provided staff with clear information about the person and the care they required. Staff were aware of people's needs and preferences and acted in accordance with their wishes.

Is the service well-led?

People we spoke with told us that the manager was 'lovely' and that they were available if they had any questions. However, we were told that it was not always possible to speak with them immediately as they would sometimes be out of the office providing care to people. Staff told us that the management team was supportive but that they were not always able to get quick answers to questions and issues.

Overall, care plans were well documented to promote continuity of care. However there was a lack of information about how people received their medicines and risk assessments were not in place for all areas of peoples care and treatment.

Staff files showed that the present recruitment systems were effective and robust.

Prior to our inspection we received concerns that staff were regularly providing personal care by themselves when the person using the service required two staff. We saw that for one person this had occurred on three occasions in one month. This puts the person at risk of unsafe and inappropriate care.

We saw that new staff completed an induction programme before they commenced employment and this was taking place on the day of our inspection. Information received from the service showed that there were gaps in people's training and development. Personnel files showed that staff supervision and annual appraisals were not being completed on a regular basis. For example, in one file we saw that the last supervision had been completed in 2012.