Background to this inspection
Updated
16 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to mainly older people living in their own houses and flats.
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
This inspection was announced.
We gave the service two working days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to support the inspection.
Inspection activity started on 24 June 2019 and ended on 27 June 2019. We visited the office location on 24 June 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We requested feedback from a sample of care workers and three relatives.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used this information to plan our inspection.
During the inspection
We spoke with the registered manager and two locality managers. We reviewed a range of records. This included two people's care records and their medicine records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance checks.
The Expert by Experience spoke on the telephone with five people and three relatives to gain their feedback on the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. Four care workers provided their views on the service. On this occasion, professionals did not provide their feedback.
Updated
16 July 2019
About the service
Raeburn Healthcare Swindon is a domiciliary care service providing personal care support to 14 people at the time of this inspection.
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
At the October 2018 inspection we found audits and checks did not effectively identify issues or record action taken to make changes and drive improvements. At this inspection we found improvements had been made.
Improvements had been made with medicine management and checks were more effective in identifying when there were issues so that action could be taken. Learning from audits took place which promoted people's safety. People’s records were more personalised and gave staff guidance on how to support people safely.
There were some improvements to the feedback on punctuality of home visits, however, people and relatives said there were issues at the week-ends, with some visits being late. The registered manager was continuously looking at ways to improve the quality of the service and people’s experiences but had yet to resolve this problem.
People and relatives confirmed they knew how to raise a complaint. Some relatives had raised complaints about the visit times which they felt were not always dealt with. The registered manager had systems in place to respond to complaints which we saw, but these had not effectively addressed the problem of late visits.
People and relatives were complimentary about the staff who supported them. They confirmed staff were kind, caring and had developed meaningful relationships with them.
People's dignity and privacy were respected, and their rights upheld. Staff involved people in all aspects of their care.
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 his practice.
People were supported to maintain good diet and hydration.
Staff were overall positive about communication between each other, with only some staff noting there could be changes to their schedule that were not always conveyed to them in a timely manner.
Staff were well supported and had the skills and knowledge to meet people's needs.
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 19 October 2018).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Raeburn Healthcare Swindon on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.