Head Office

Ranger Home Care - Main Office is a domiciliary care agency providing live-in care services to people in their own homes. The service provides support to younger adults and older people, people living with dementia, people with a disability and people with a sensory impairment. At the time of our inspection there were 33 people using the service.

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 worked with people to identify and achieve goals, promoting very positive outcomes for people around their health, wellbeing, communication needs and independence. The provider worked to find the right care solution for each individual, working creatively to overcome obstacles or barriers to people receiving the right care. Staff had an extensive knowledge of people’s needs and were dedicated to working in partnership with them to ensure their views and wishes were central to how care was planned, carried out and reviewed.

The registered manager and senior staff were caring, competent and professional. There were effective systems to oversee the quality of care and engage people when gaining feedback about care. Staff told us they felt supported in their role and listened to by management staff. The provider promoted a positive culture which achieved excellent outcomes for people.

People received personalised care in line with their needs. Staff supported people to lead active and full lives and stay in contact with those important to them. There were systems in place to help ensure complaints or concerns were investigated appropriately. Staff were provided training and support to help ensure people received responsive and empathetic care at the end of their lives.

The provider had systems in place to protect people from the risk of abuse. There were systems in place to assess and reduce risks, including risks associated with people’s medical conditions or home environments. People were supported to take their medicines as prescribed and the provider’s medicines policy had been developed in line with best practice guidelines. Staff had received training in infection control and understood good practice in reducing the risk of infections spreading.

Staff had the training and skills to provide people with effective care. The provider had systems in place to ensure people’s needs were fully assessed, and appropriate care was put in place. Staff worked effectively with people, relatives, and professionals to promote positive outcomes in people’s health and wellbeing. 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.

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 12 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

Ranger Home Care Ltd offers personal care to people in their own homes by providing a care worker [to be referred to as care staff] who provides ‘live in’ care and support. The service is provided to both younger and older people and those who require end of life care. On the day of the inspection 19 people received the regulated activity of personal care.

The service had a registered manager. 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.

There was guidance and procedures in place to protect people from the risks of harm and abuse. There were enough staff to support people safely. The provider had an effective recruitment process to make sure the staff they employed were suitable to work in a care setting.

Risks to people were assessed and action was taken to minimise any avoidable harm. Medicines were managed safely and administered as prescribed and staff had regular competency checks to help ensure they were following best practice.

People were protected from the risk of acquiring an infection during the provision of their personal care. Processes were in place to ensure any incidents were reflected upon and relevant changes made for people's future safety.

People's individual needs had been assessed and from that a care plan was created. Staff were trained to support people with an array of health care needs, in line with recognised best practice. People were supported by staff who had the required skills and training to meet their needs. Where required, staff completed specialist training to meet individual's needs. People were supported to eat and drink sufficient for their needs.

Staff worked both within the service and with external organisations to ensure people received effective care. People were supported by staff to ensure their healthcare needs were met and healthcare professionals' guidance was followed.

The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The service did not currently support any individuals who required assessments under the MCA.

People reported they were treated in a kind and caring manner by staff. People were supported by staff to express their views and to be involved in decisions about their care. People's independence was promoted by staff who encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The registered manager confirmed that should people need information in an alternative way that this would be arranged to meet the accessible information standard.

The service was responsive and involved people in developing their care plans, which were detailed and personalised to ensure their individual preferences were known. People's care plans had information about people's care needs, their wishes regarding independence and any risks identified and how to minimise these. If a person's needs changed then their care plans were updated to reflect this.

Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

People were well supported at the end of their life and the service worked with specialist agencies to ensure people could stay in their homes where possible at the end of their lives.

The service was well-led by the registered manager who provided clear and direct leadership, which inspired staff to provide good quality care. The safety and quality of the support people received were effectively monitored and any identified shortfalls were acted upon to drive continuous improvement of the service.