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Inspection carried out on 1 May 2018

During a routine inspection

The inspection at the provider's office took place on 1 and 15 May 2018 for seven and a half hours. The inspection was announced on both days. The provider was given 24 hours’ notice because the location provides a small domiciliary care service and we needed to be sure that someone would be in. The inspection was carried out by one inspector.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. However, the rating for Well-Led has deteriorated from Good to Requires Improvement.

Ribble Care Limited is a domiciliary care agency providing support and care to people in their own homes. This may be companionship, domestic help like shopping, or help with personal care, like washing and dressing. The main office is based in Settle, and the agency provides services in Settle and surrounding areas.

Not everyone using the service receives the regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. We also take into account any wider social care provided. At the time of our inspection there were 28 people who used the service for personal care support.

There was a registered manager in post. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

The provider, who was also the registered manager, spent most of their time carrying out care visits and employed a compliance manager to run the service from the office. However, the provider carried out no formal monitoring of the service to assess quality. This meant the provider could not be certain the systems and processes used by the compliance manager fully promoted the health, safety and welfare of people who used the service.

People who used the service and care staff all spoke positively about the way the service was managed. The compliance manager completed audits of records and monitored staff performance to make sure any issues were identified and acted on promptly.

People told us they felt safe. Care staff understood how to keep people safe and any potential risks were identified and managed. Risk management plans were in place to ensure people’s safe care. Care staff knew how to protect people from risks associated with harm and abuse. Safeguarding procedures and policies were in place. Staff were aware of their responsibilities to identify and report any allegations of abuse to the local authority.

There were sufficient staff to provide the service people needed. Safe recruitment practices were followed. Care workers felt well supported and received appropriate training.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. Care workers understood people needed to consent to their care and were confident they supported people to make their own decisions. People received assistance with meals and healthcare when required. This supported people to maintain their health and well-being.

People told us they were happy with the care they received and were complimentary about the care workers who supported them. People said staff knew them well and treated them with kindness. Staff understood the importance of treating people with dignity and respect and promoting their independence.

People told us they had no complaints and when they had raised any issues, they were dealt with promptly. People were inv

Inspection carried out on 27 October 2015 and 1 November 2015

During a routine inspection

The inspection visit to the domiciliary agency care office was carried out on 27 October 2015. Telephone contact was made with people using the service and staff on 1 November 2015, this included weekend and evening calls in order to catch people in. We gave the provider 72 hours’ notice of the inspection in order to ensure people we needed to speak with were available.

The last inspection took place on 23 July 2013 and the service was meeting the regulations we assessed at that time.

Ribble Care Ltd is owned and managed by Mrs Delphine H Illston. The service is a domiciliary care agency providing support and care to people in their own homes. This may be companionship, domestic help like shopping, or help with personal care, like washing and dressing. The main office is based in Settle, and the agency provides services to people in Settle and surrounding areas.

The service had a registered manager, who is also the registered provider. 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 told us they received safe care, which was reliable and consistent. The service had sufficient staff to meet people’s needs, and people were given the time they needed to ensure their care needs were being fully met.

Medicines were administered safely, the service had an up to date medication policy and all of the staff we spoke with explained they attended training before they could administer medication.

People were protected from avoidable harm and staff knew what to do if they suspected abuse. Risks to people were assessed and risk management plans were in place.

Staff had the skills, guidance, support and training they needed to deliver care effectively. All of the staff we spoke with told us they were well supported by each other and the management team.

People were supported to have a good diet. Their healthcare needs were met, and staff referred people for extra clinical or health support when this was needed.

The service was working to the principles of the Mental Capacity Act, 2005 and care staff supported people to make their own choices about their care.

Care staff spoke with enthusiasm about delivering a good standard of care. They told us they would be happy for their family member to receive care from the service. There was a focus on promoting people’s independence and maintaining their privacy.

Staff morale was high. The management team and staff were clear about their roles and responsibilities.

People spoke highly about the support they received. People told us they were treated well and that the service not only considered the person they were supporting but their family and friends. Care plans were developed with the person or their representative and reviewed on a regular basis. Care plans were detailed, they took into account people’s views and preferences.

Staff referred people to community resources to reduce social isolation, and there was a focus on improving people’s quality of life.

The service requested feedback from people about the service and some people we spoke with said they had recently completed a questionnaire from Ribble Care to give their views. People told us when they had raised any issues with the service, they were quick to respond and provide a solution. This showed a commitment to service improvement and listening to feedback from people.

People knew how to make complaints. The service investigated complaints thoroughly and was keen to improve the service.

The registered manager demonstrated a commitment to ongoing service development. The service had effective systems in place to monitor the quality of care provided to people.

People told us they would recommend the service to others.

Inspection carried out on 23 July 2013

During a routine inspection

The people we spoke with said they received a good service. One person told us, �I get the care I need at the time I want it.� Another person told us, us "The staff are kind, polite and courteous.�

People told us the care they received was of a good standard and that staff arrived on time. One person told us, �I know what time to expect them and I can plan my days accordingly.�

The agency had clear systems in place for supporting people with medication and staff were trained in the safe handling of medicines.

People are included and involved in decisions about the care and support they received.

People received safe and appropriate care, which met their needs.

The recruitment process is robust and we saw evidence that only suitable people worked for the agency. All staff told us they thought morale was high. They said the management team were supportive and approachable. They felt there were enough skilled and experienced staff to meet people's needs, we saw evidence of this.

People are given written information about how to raise a concern and have a copy of this process in their home, to refer to.

Inspection carried out on 13 February 2013

During an inspection looking at part of the service

Our inspection of 31 October 2012 resulted in the provider having to take action to address three main outcome areas. We found that people who used the service were not fully protected from the risk of abuse, because the provider had not taken reasonable steps to train staff on how to identify the possibility of abuse and prevent abuse from happening. We also found that people were cared for, or supported by, staff who may not be suitably qualified, skilled and experienced, because pre employment checks had not been carried out on all staff, before they were recruited and allowed to provide care. The provider also needed to formalise the arrangements for the supervision and checking of staff and provide additional training.

The provider wrote to us and provided an 'action plan' which told us what they would do to address these shortfalls and that this would be completed before the beginning of December 2012. We found at this visit that improvements had been made and we saw records to confirm this.

We did not speak to people about their experiences as part of this inspection, but did take the opportunity to talk to staff on duty. At the last inspection people who used the service and their representatives spoke very positively about the service they received from Ribble Care.

Inspection carried out on 31 October 2012

During a routine inspection

The agency was described as a �professional� organisation by one representative of a client. Another person told us, �The care workers are wonderful and they give us peace of mind because we know our relative is well looked after.� All the people we spoke with were happy with staff from the agency.

People's needs were assessed and their care and treatment was planned and delivered in line with their individual care plans. One person told us, when referring to the care worker who visits, �She knows what I like and knows me well, we get on famously.� Another person told us, �They always make sure I am comfortable and I am completely satisfied with them.�

All of the people we spoke with said they felt fully supported by the agency staff. When asked whether staff met people�s changing needs one person said, �Yes, they are sensitive and know what works for me. They have made changes which suit me better.�