Archived: Raeburn Healthcare Swindon

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.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It currently provides a service to older adults. At the time of our inspection 13 people were receiving personal care in their home and their care was paid for through either the council or people were paying for their own care.

There were various audits and monitoring checks in place. There were some systems in place to ensure people safely received their medicines. However, due to recording errors and a lack of effective medicine administration record audits, we could not be confident that people always received their medicines correctly. Audits had not always been recorded and did not always effectively identify where improvements needed to be made.

This was a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

There were two registered managers in post. 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.

We received mixed feedback on the service from people using the service and their relatives. Several people and their relatives told us there were issues with punctuality and changes all the time with the care workers.

We did receive positive feedback, with everyone telling us, the care workers were lovely, kind and caring.

Care workers also gave us varied feedback. The main issues were a lack of communication between the staff in the office and the care workers. They also commented on the changes frequently with the rota and a lack of support from the office staff and management.

However, two care workers highlighted more positive areas of the service, telling us the service was fair and helpful and that the hours suited them and they were happy working for the service.

The registered manager was aware of the improvements that needed to be made for people using the service and for the care workers and was trying to address the issues by regularly recruiting new care workers so that a consistent service could be offered to people. They also planned to offer more team meetings and supervisions to care workers so they had the chance to voice their concerns and issues.

People's needs and potential risks were assessed and the support people needed was recorded and reviewed. Improvements needed to be made to ensure all information in people's care records was accurate and up to date. People's health and nutritional needs were assessed and they were supported with these areas of their lives if this was required.

People and their relatives told us they did not feel their complaints were always acted on and addressed. There were systems in place to manage and respond to complaints but these needed to ensure they fully resolved the concerns people had raised to the provider.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The systems in the service supported this practice.

There were sufficient numbers of care workers employed to meet people's needs. Recruitment checks were in place to obtain information about new staff before they were allowed to support people. Improvements to the information obtained needed to be made.

The provider had arrangements to help protect people from the risk of the spread of infection as the care workers wore protective equipment, such as gloves and aprons, when providing care.