Background to this inspection
Updated
21 April 2020
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 completed by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.
The service had two managers registered with the Care Quality Commission. They jointly shared the management of the service. The registered managers were also the registered providers of the service. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
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.
Inspection activity started on 5 February and ended on 19 February 2020. We visited the office location on 6 February 2020.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
At the office visit, we reviewed a range of records. This included people’s care records and multiple medication records. We spoke with the registered managers and a senior care worker. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We visited and spoke with four people in their own homes to gain their experiences of the service.
After the inspection
We continued to seek further evidence from the providers to validate evidence found.
We spoke with a further three people and five relatives. We contacted six health and social care professionals and all responded. We contacted all ten care workers and received six responses.
Updated
21 April 2020
About the service
Rural Care is a domiciliary care agency providing person care in people’s own homes in the community.
CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection, 16 people were receiving care from the service and all received personal care. The service provides care and support to people living in rural areas in the surrounding area of Bideford.
People’s experience of using this service and what we found
Rural Care put people at the centre of their care and support. The service was managed and run on people’s individual needs, choices and interests.
People felt safe and trusted the staff who cared for them. Staff were motivated, passionate and genuinely ‘cared’ in their roles. A relative said, “From the minute they arrived, the care worker put an arm on my relative’s shoulder and said, ‘It will be fine’." Another said, “I feel safe with them … nothing they could do is better … the little things make a difference … they are great.”
People, relatives and care professionals told us the staff team gave excellent care and were extremely caring, compassionate and kind. Everyone told us the service was well led and were complimentary of the two registered managers. They said, without hesitation, they would recommend the service to others.
People received a very personalised service to meet their specific needs and preferences. Staff worked with people and their families to put together a plan of care which was truly person centred and achieved people’s desired outcomes and wishes.
People were protected because risks had been assessed and any measures required put in place. They received their medicines in a safe way and were encouraged to eat and drink well.
People benefitted from a small staff team who knew people extremely well. Staff were consistent and effective and positive relationships had been developed. Families were involved in people’s care and told us staff were sensitive and empathetic to their needs as well. Staff identified any responded to changes in people’s needs and took the necessary action.
People at the end of their lives received extremely compassionate and loving care. Staff spent time with people and their families at this stage of their lives and treated people with dignity and respect. Looking after people at the end of their lives was regarded as a privilege by the staff team. A relative said, “They are all angels for which I will always hold them very dearly.”
Staff were recruited safely, well trained and supported by the registered managers. They were motivated and passionate in their roles. There was an open and inclusive culture where staff felt valued and included.
Staff regularly went the extra mile for people. Staff comments included, “I believe if you are not willing to go above and beyond in this job then you shouldn't be doing it” … I do what I need to” and “We all genuinely care for our clients and look at them in a holistic way.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Since the previous inspection, the registered managers (who are also the providers) have continued to develop and improve the service. This had led to improved outcomes for people and a high level of support. The registered managers worked in partnership with other professionals and organisations to share best practice and work closely together in a seamless service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (report published 14 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.