Archived: Richard Norman Care Coordinators

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

Inspection team:

This inspection was carried out by one inspector.

Service and service type:

Richard Norman Care Coordinators is a domiciliary care agency. It provides personal care to people living in their own homes. It provides this service to older and younger adults, some of whom presented with physical disabilities. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

What we did: before the inspection

We reviewed information we held about the service. This included notifications the provider is required by law to send us about events that happen within 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.

During our inspection

We spoke with two people, one relative, two staff and the registered manager. We reviewed the care records of five people and files of three staff which included recruitment, supervision and training records. We also reviewed records related to the management of the service.

After the inspection

We requested additional information about the provider’s quality audits from the registered manager and contacted two health and social care professionals for their views regarding the care and support being provided to people.

The last inspection of the service took place on 5 July 2017 and it was rated Good. At this inspection we found the service requires improvement.

The service had not planned and developed the service in a way that ensured continuous quality improvement. People did not always receive their care visits from staff at the time agreed. There were concerns about staff time-keeping and attendance. We found that the service did not always review incidents relating to missed and late visits so lessons could be learned and appropriate actions put in place to improve the service.

The service had a registered manager. 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 handled and administered medicine to people in a safe way. Staff had been trained the safe administration of medicines and they understood and followed the organisation’s medicines policy. Risk management plans were in place to keep people safe from avoidable harm. Staff recruited to work at the service underwent thorough checks. Staff understood how to recognise signs of abuse and how to report any concerns appropriately.

Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. 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 support this practice. Staff told us they felt supported in their roles. Record showed staff were trained and they received induction when they started; and they were regularly supported through supervisions and annual appraisals. People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. People were supported to arrange appointments to ensure their health needs were met. The service worked with other professionals to ensure people’s care was well-coordinated.

People told us staff treated them with kindness and respected their dignity. Staff cared for people in line with their preferences. People were given choice about their care and they and their relatives were involved in their care planning. Staff encouraged and enabled people to do what they can do for themselves to keep them active and maintain their independence.

Staff supported people with their care needs as stipulated in their care plans. Care plans were reviewed and updated regularly to reflect people’s changing needs. People received the end-of-care they wished.

People and their relatives were given opportunity to share their views about the service. People knew how to complain. The registered manager investigated and responded to complaints and concerns appropriately.

We found we found a breach of regulation in relation to good governance. You can see what action we told the provider to take at the back of the full version of the report.

At the time of the inspection, there was a registered manager. 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.

People felt safe and were supported by staff who knew how to keep them safe. Risks to people's health and safety were assessed and appropriately managed and people were supported by appropriate numbers of staff. Robust staff recruitment procedures helped to keep people safe. People received the support they needed to safely manage their medicines.

Staff had the knowledge and skills to care for people effectively and felt well supported by appropriate training and effective supervision. People were all able to make choices and decisions about their care sometimes with the support of their relatives. People received support where they needed it to access a range of healthcare services.

Relatives told us staff were consistently kind and caring and established positive relationships with people and with them. They told us staff valued people, treated them with respect and helped preserve their dignity, their rights, choice and independence.

We found there was consistency in the provision of care for people and this enabled caring relationships to be developed. People were supported by staff who understood them and their needs, wishes and preferences.

People and their relatives were able to be involved in the planning and reviewing of their care.

People were provided with support that was responsive to their changing needs and staff helped people to maintain any interests they had. People felt able to make a complaint and the provider had taken action to raise awareness of the complaints procedure.

We received positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and there were arrangements for people to be asked for their opinions via surveys. Action plans were developed where required to address areas for improvements.