Reliant Care Ltd

Reliant Care Ltd provides support to people living in their own homes and in supported living settings. The supported living houses are designed to support between three and 11 people with shared communal facilities such as kitchens, lounges and bathrooms. Most people receiving support have mental health needs. The provider also supports people with learning disabilities and autistic spectrum conditions. At the time of our inspection the service was supporting seven people with personal care needs. Not everyone who used the service received personal care. 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.

People’s experience of using this service and what we found

The provider had made improvements to their quality assurance systems since our last inspection. Regular monitoring of a wide range of safety and care issues were taking place and actions taken when concerns were identified. However, we found failures in the management, recording and monitoring of people’s monies where these were looked after by staff. Although there was no evidence people were put at risk, the provider did not have systems in place to reduce the likelihood of financial abuse in the future.

People’s prescribed medicines were safely managed. Staff had received training in the safe administration of medicines.

People had up to date assessments including assessments of risk. These included guidance for staff on managing risk and had been updated when there were changes in people’s care and support needs.

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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to make choices. They were enabled to participate in activities as independently as possible. Staff had received training to support people to reduce their anxieties and behaviours.

Right Care: Staff engaged with people using methods they understood. Actions had been taken to ensure people’s privacy and dignity was respected.

Right Culture: The provider had appointed senior staff who understood the needs of people with learning disabilities and autism. Staff received the support and information they required to support people’s needs. We observed positive interactions between people and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 6 April 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We received concerns in relation to people’s safety, staff training and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Reliant Care Ltd on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the safe management of people's monies.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Reliant Care Ltd provides support to people living in their own homes and in supported living settings. The supported living houses are designed to support between three and 11 people with shared communal facilities such as kitchens, lounges and bathrooms. Offices and staff ‘sleep-in’ rooms, as required, were provided at each location. Most people receiving support have mental health needs. The provider also supports people with learning disabilities and autistic spectrum conditions. At the time of our inspection the service was supporting four people with personal care needs.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the key questions of Safe and Well-led the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support: The service did not effectively support people in relation to recognised models of care for people with a learning disability, and people with autism. Staff had not received training in understanding learning disabilities and autism

Right care: The privacy and dignity of people at one supported living house was compromised as there were no curtains or blinds to their bedrooms and communal areas which were overlooked from the street and neighbours gardens.

Right culture: Staff and managers had not explored the use of communication tools to fully engage people in making decisions. The absence of communication plans and strategies to ensure the environment was predictable to people increased people's dependence on staff for their basic needs.

Staff had not received regular supervision to support their practice. The provider had recently recommenced staff supervision sessions. However, some staff had not yet had a recent supervision session with their line manager. Staff working with people with specific conditions had not received training in relation to these.

People’s prescribed medicines were not always safely stored. A medicine requiring refrigeration was stored in a communal fridge and could be accessible to people, staff and visitors at the house. Following our inspection, the provider purchased a lockable medicines fridge.

Although the provider had undertaken some quality assurance monitoring, these had focused on health and safety, and had not identified concerns identified during this inspection. The registered manager had developed a more detailed quality assurance recording template. However, this had not yet been introduced.

People told us they were satisfied with the service. We observed positive interactions between people and staff.

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 (published 29 May 2019).

Why we inspected

We received concerns in relation to staffing, medicines and management. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Reliant Care Ltd on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have found evidence that the provider needs to make improvement. We identified breaches of regulation in relation to safe care and treatment, staffing and good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow-up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

People were provided with a service that was personalised, met their individual needs and preferences and prompted their independence.

Staff knew people well and understood their needs. Staff were provided with the training, support and guidance they needed to carry out their role and responsibilities. This included providing people with individualised care and support.

People’s care was planned with the involvement of people using the service. People were encouraged to make decisions about the support that they needed from staff and to make choices about their lives.

People received consistency of care and support from a staff team that communicated well with each other about people’s needs. Staff told us they were kept well informed about people’s current needs and always reported any changes in people’s needs to the registered manager and to other staff.

People told us that they were satisfied with the service they received. We saw staff engage with people in a respectful and friendly way. Staff listened to people and respected the choices they made about their day to day lives.

There were opportunities for people to follow their interests and take part in activities that they enjoyed. People were supported to develop their skills so that they were more able to live independently within the local community.

Staff we spoke with understood the importance of respecting people's privacy and dignity. They had a good knowledge of people’s equality and diversity needs and spoke of the importance of respecting people’s differences.

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 supported this practice.

The service assessed and managed risks to ensure that people received personal care and support safely.

Systems were in place to assess and monitor the quality and delivery of care to people and drive improvement. Development and improvements to the services were made when needed.

People had opportunities to provide feedback about the service that they received, and action was taken to address any concerns.

The provider had systems in place to manage and resolve complaints.

Rating at last inspection: This was the service's first inspection.

Why we inspected: We inspected the service as part of our inspection schedule methodology for new registered services which had not been rated before.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk