Rosebud Homecare Ltd

Rosebud Homecare Ltd is a domiciliary care service providing personal to people in their own homes. 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. At the time of our inspection there were 9 people receiving personal care using the service.

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

Systems and processes were not always in place to ensure that documentation was complete, dated and reviewed.

People were supported safely by staff. Systems and processes were in place to monitor this. Recruitment procedures helped ensure only suitable staff were employed to support people. There were sufficient staff to meet people’s needs.

People received the support they required with their medicines. Staff worked consistently within the providers policy and procedure for infection prevention and control.

People’s had their needs assessed and reviewed before using the service. People’s health care needs were documented, and staff knew when to liaise with health care professionals . Staff had the knowledge and experience to meet people’s needs and were trained appropriately.

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.

Staff were supported through ongoing monitoring and good communication. Information was shared with staff to support the delivery of good quality care.

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 on 1 August 2019.

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.

Why we inspected

We carried out an announced comprehensive inspection of this service on 1 July 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

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

Rosebud Homecare Limited is a domiciliary care agency providing personal care to a range of people living in their own homes. At the time of the inspection 24 people were receiving personal care.

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

Staff were not always formally trained to meet people’s needs. Some healthcare tasks were being carried out by staff, who had not received formal or up to date training to ensure their practice was safe.

Audits carried out were mostly effective, however there was no training audit, and the lack of staff training in certain areas had not been recognised.

CQC ratings had not been displayed within the service.

People told us they received safe care. Staff understood safeguarding procedures.

Risk assessments were in place to manage risks within people’s lives.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

Staffing support matched the level of assessed needs within the service during our inspection.

Staff were supervised well and felt confident in their roles.

When required, people were supported with food and drink and to have a varied diet.

When required, staff ensured people’s healthcare needs were met, and people had access to health professionals as required.

Staff treated people with kindness, dignity and respect and spent time getting to know them.

Care plans reflected people likes dislikes and preferences.

People and their family were involved in their own care planning as much as was possible.

A complaints system was in place and was used effectively.

The registered manager was open and honest, and worked in partnership with outside agencies to improve people’s support when required

The service had a registered manager in place, and staff felt well supported by them.

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. People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives .

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 (report published 12/01/2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Rosebud Homecare Ltd is registered to provide personal care to people in their own homes. They provide care to a people in and around Milton Keynes with a range of support needs, including older people, people living with dementia and people living with learning disabilities. When we carried out this inspection there were 36 people receiving care from the service.

The service had a registered manager 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. The registered manager was not available during our inspection, however; we were able to speak with two other managers, with whom they worked closely to run the service.

People were protected from harm or abuse when staff were providing them with care. There were systems in place to manage incidents and staff were aware of reporting procedures if incidents occurred. Risks were assessed and suitable control measures put in place which still allowed people to maintain as much independence as possible. There were sufficient numbers of staff to ensure that people's needs were met and recruitment practices ensured that staff were of good character and suitable for their roles. Staff members were also able to help people with the administration of their medicines if required. Systems were in place to record when medicines were given and were regularly checked to ensure there were no errors.

Staff members received training to provide them with the skills they needed to perform their roles. This included induction and mandatory training, as well as additional courses which the provider sourced from a local college, to help develop staff knowledge and performance. Staff members were also provided with support and supervision sessions to allow them to discuss any concerns or comments they may have and to explore additional learning and development requirements.

The consent of people to their care and support arrangements was sought and staff took steps to ensure they were respectful of people's wishes. If people were unable to make decisions for themselves, the service had systems in place to ensure the principles of the Mental Capacity Act 2005 were followed. People were encouraged to prepare their own meals and drinks, but staff were able to provide support in this area if required. Similarly, they were able to support people to book and attend healthcare appointments as and when this was necessary.

There were positive relationships between people and members of staff. Staff treated people with kindness and compassion and took the time to get to know them and their interests whilst providing their care. The service had involved people in producing their care plans to ensure that care was going to be provided in the way they wanted it to be. In addition, people and their family members were provided with information about the service and what they could expect from them. Staff members were sensitive of the need to preserve people's dignity and respect at all times, and made sure they upheld their privacy when providing their care.

Care was person-centred and reflective of people's individual needs and wishes. The care plans had detailed information for staff, so they knew what to do on each care visit. These were regularly reviewed so that any changes in how people needed their care to be provided were recorded in the care plan. People were able to provide the service with feedback, including comments and complaints, and this was taken seriously by the service. There were systems in place to record feedback and this showed that appropriate action was taken in response to the feedback given.

There was a positive culture at the service. Staff members were motivated to perform their roles and felt well supported by the provider. The ethos of the service was clear and people were at the forefront of everything they did. There was clear management at the service and both people and staff felt that they were accessible and supportive when they needed them. Quality assurance systems were in place at the service, which allowed them to assess and monitor their performance and to identify areas for improvement.

We asked the provider to submit an action plan to tell us how they would meet these regulations in the future; they stated that they would be meeting them by 25 May 2016. During this inspection we returned to see if the service had made the improvements they stated in their action plan. We found that the provider was now meeting these regulations.

We undertook this focused inspection on 11 July 2016, to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosebud Homecare Ltd on our website at www.cqc.org.uk.

Rosebud Homecare Ltd is registered to provide personal care to people in their own homes. They operate in and around the Milton Keynes area. On the day of our inspection there were 41 people receiving care from the service.

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.

Improvements had been made to the systems in place for recording medication administration at the service. Medication Administration Record (MAR) charts were retained by the service and used to demonstrate when medication was administered by members of staff. These MAR charts were collected and reviewed by senior staff and used to identify any concerns or staff training requirements.

The registered manager and office staff had familiarised themselves with regulations and associated statutory requirements, such as sending the CQC notifications of certain incidents, for example, safeguarding concerns. They had implemented systems to ensure that these notifications were sent in a timely manner if required. They had also introduced a number of quality assurance systems, including audits and satisfaction surveys, to help them assess, monitor and improve the care being provided by the service.

Each person we spoke with was very happy with the standard of care and support provided by the staff provided by 'Rosebud'. They confirmed that the service was reliable and that they consistently received the support that had been agreed with them. One person commented that the staff were 'very kind and considerate'. Another person said their service was "very reliable" and that the staff were "conscientious".

We found that people's preferences for the way they wanted their support to be provided had been taken into account and acted upon. We found that people were provided with the agreed practical assistance and support they needed to enable them to live independently at home.

We found from speaking with staff, from looking at records kept at the agency office and in people's own homes, that 'Rosebud Homecare' was well-managed. We saw that people received a reliable, safe and effective service.