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Right at Home North Cheshire and Leigh Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 9 August 2018

We carried out an announced inspection of Right at Home North Cheshire and Leigh on 23, 24 and 25 May 2018. The service was newly registered in April 2017 and this was the first time it had been inspected.

Right at Home North Cheshire and Leigh is a domiciliary care agency which operates as a franchise of Right at Home UK. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older adults and people living with dementia. Not everyone using Right at Home North Cheshire and Leigh 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. At the time of inspection 13 people were receiving a regulated activity.

At the time of the inspection there was a registered manger in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of inspection, the registered manager was on leave. In their absence the service was being run by the deputy manager and nominated individual, who was also the franchisee.

Right at Home North Cheshire and Leigh ensured people were at the heart of their care and support. People received a high standard of person centred care by staff; referred to as caregivers within the service, who were reported to be exceptionally kind, caring and considerate. People and relatives we spoke with, were extremely positive about the relationships they had formed with both caregivers and the service as a whole.

We saw caregivers had gone above and beyond and worked in their own time, or gone out of their way for the benefit of people using the service, to ensure their needs had been met or to provide them with unexpected treats and surprises. The service had also ensured a person’s holidays could continue following the death of their main carer, by ensuring the holiday accommodation was assessed and fitted with matching aids and adaptations, as well as supporting the trip, to aid consistency.

People, their relatives and the caregivers we spoke with, told us the service was extremely well-led and managed. Excellent communication was central to the service’s ethos and this was evidenced in the number of meetings, reviews and checks which had been completed.

People told us they felt safe as a result of the care and support they received. The service had comprehensive safeguarding policies and procedures in place. Caregivers had all received training in safeguarding vulnerable adults, which was regularly refreshed and were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns. Caregivers were confident any concerns raised would be actioned by management or the franchisee.

Caregivers clearly knew the people they supported including their likes, dislikes and interests and the service ensured a small and consistent team worked with each person, with the person involved in this decision-making process.

The service strove to ensure the number of caregiver hours available exceeded the amount of care hours they needed to provide, to ensure people received a punctual and consistent service. Caregivers rosters were planned four weeks in advance and sent to caregivers two weeks in advance, to ensure any issues could be addressed in a timely manner. The service was also mindful of caregivers’ work life balance and the importance of forward planning, to enable them to organise their lives outside of work.

To ensure high quality care and consistency continued to be delivered, the service completed regular monitoring, spot checks an

Inspection areas

Safe

Good

Updated 9 August 2018

The service was safe.

The service had systems and procedures in place to protect people from harm and keep them safe. The service had robust recruitment procedures in place, to prevent unsuitable people from working with vulnerable people and caregivers had received training in safeguarding and knew how to raise concerns.

Staffing levels were sufficient to meet people’s needs, with effective monitoring in place to ensure call times had been adhered to.

The service had safe medicines management procedures in place. People told us they received their medicines safely and when necessary.

Effective

Good

Updated 9 August 2018

The service was effective.

Caregivers were complimentary about the training provided, reporting more than enough was provided to help them carry out their roles successfully. They were also provided with regular support and supervision.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA).

Care plans demonstrated that people had been involved in discussions around their care. People had consented to their care or decisions had been made in their best interest by their next of kin or legal representative.

Caring

Outstanding

Updated 9 August 2018

The service was extremely caring.

Without exception, people and their relatives spoke positively about the care received, praised the caregivers and spoke highly about the relationships they had developed with them.

People benefitted from a strong person-centred culture. Caregivers were extremely knowledgeable about the importance of promoting people’s independence and providing choice, which was evidenced in people’s care records.

Caregivers went above and beyond, exceeding their responsibilities, and carried out tasks in their own time for the benefit of people using the service.

Responsive

Outstanding

Updated 9 August 2018

The service was extremely responsive.

The service was extremely responsive to people’s changing needs with numerous examples noted where the service had exceeded expectation to ensure people’s needs had been met.

Caregivers involved people, their relatives and/or representative fully in their care and support, which ensured they felt listened to, valued and empowered.

Care plans were extremely person-centred and individualised with information about people’s life history, likes, dislikes, how they wished to be supported and the goals they wanted to achieve through their care and support.

Well-led

Outstanding

Updated 9 August 2018

The service was extremely well-led.

The service worked in partnership with others, to provide a high quality and innovative service and ensure they were involved in both the local and wider community.

Both the people using the service and caregivers working there felt the service was exceptionally well-led and managed and caregivers reported feeling supported in their roles and confident in being listened to if they raised issues or concerns.

Audits and monitoring tools were in place and used regularly to assess the quality of the service, with action points generated and details of progress clearly documented.