Archived: RV Care Limited Surrey

Updated 9 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 September 2016 and was conducted by two inspectors.

Before the inspection, we reviewed all the information we held about the provider. This included information sent to us by the provider in the form of notifications and safeguarding adult referrals made to the local authority. A notification is information about important events which the provider is required to tell us about by law.

On this occasion we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with eight people, two relatives, the registered manager, the regional manager and four care staff.

We spent time observing care and support staff interacting with people throughout the day of inspection, in the communal areas and in people’s own homes.

We reviewed a variety of documents which included four people’s support plans, risk assessments, four weeks of duty rotas, quality assurance records. We also looked at a range of the provider’s policy documents. We asked the registered manager to send us some additional information following our visit, which they did.

The last CQC inspection was 30 April 2014 when no concerns were identified.

Updated 9 November 2016

RV Care Limited Surrey provides a domiciliary care service to people who lived in the Woking Retirement Village and for people who lived in the Rugby Retirement Village. Retirement Villages offer independent housing options for people over a certain age. The support people received is for tasks such as meal preparation and cooking, managing personal correspondence, house work and laundry. There are 15 people currently who receive support with their personal care across Woking and Rugby. The registered office is based in Woking and there is a satellite office in Rugby. Each office is managed by a care co-ordinater.

The service was run by a registered manager, who was present on the day of the inspection visit. 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 and associated Regulations about how the service is run.

The registered manager had not always ensured that there were robust procedures in place to monitor, evaluate and improve the quality of care provided. There were systems in place to obtain feedback from people; however they were not always used within the providers stated timeframe.

Some people’s human rights were not always protected. Where people may have lacked capacity to make some decisions about their care, their next of kin had made decisions without the legal right to do so. Staff were heard to ask peoples consent before they provided care.

Risks to people were not always managed. There were inconsistencies in the recording and management of risks. The registered manager had a system in place for reviewing incidents and accidents that happened but actions taken were not always recorded. The regional manager had identified this in their quality assurance checks.

Most people self-administered, obtained and stored their own medicine. However the registered manager on the day was to begin supporting three people with prompting and administering medicines. The registered manager had not ensured that the staff were competent to administer these medicines.

People were not always protected from avoidable harm. The registered manager did not always recognise when there maybe potential safeguarding concerns for people. We have made a recommendation. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

Staff were not always recruited safely. They had a DBS check in place, however there were some gaps in the recruitment records of staff, for example some files lacked a photograph, other gaps in employment history.

The service did not always support people to maintain their health and well-being. There were inconsistencies as to how staff supported people to access relevant health and social professionals. We have made a recommendation.

People told us that they thought that staff had the right training and skills to support people. However, there were inconsistencies with staff being supervised, as some staff received regular supervision whilst for others it was infrequent.

People received personalised care. However there were inconsistencies in how this was recorded in people’s care plans. Some care plans contained sufficient information to guide staff in what support was needed, whilst others lacked detail and personalisation. We have made a recommendation.

People told us that they know how to make a complaint. One complaint had been received in the last year, and this had been dealt with in line with the service policy.

People told us that staff were kind and caring. Staff knew people’s likes and preferences and told us about the individual needs of people. Staff respected people’s privacy and dignity.

People were involved in their care and had signed their care plans.

There were sufficient staff in place to keep people staff. People told us that late calls were rare. When calls were late people said staff always called them to explain why and that they would be there soon.

Staff knew how to respond in an emergency. The service had a business continuity plan in place which told staff how to support people if there was an emergency.

People did not always know who the registered manager was. The regional manager told us that people had details of how to contact the registered manager in their handbook. People told us that the thought the co-ordinators were approachable. Staff told us that they felt supported by the registered manager.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what we told the provider to do at the back of the report.