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Rupaal Care and Training Ltd Good

Reports


Inspection carried out on 5 October 2020

During an inspection looking at part of the service

About the service

Rupaal Care and Training Ltd is a domiciliary care service providing personal care to people living in their own homes. The service supports people living with dementia and people with mild learning disabilities and physical disabilities. At the time of this inspection the service was supporting seven people.

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

Since the last inspection the registered manager had implemented systems and processes to address the issues we had identified at the last inspection.

People and relatives were happy with the care and support that they received from this service and spoke positively of the registered manager and the way in which care was delivered.

People and relatives told us they felt safe receiving care and support from their allocated care staff. Care staff spoke passionately about keeping people safe and knew the actions they would take if they had any concerns.

People’s care plans recorded risks associated with their health, medical and care needs with clear direction to care staff on how to minimise identified risks to keep people safe from harm.

People were supported by a regular team of care staff who people knew well. They arrived on time and supported them with their needs. Relevant and appropriate checks had been completed on prospective staff wishing to work with the service to ensure their suitability for the role.

People received their medicines safely and as prescribed. Policies and systems in place supported this.

Care staff had access to the required personal protective equipment (PPE), information and guidance to prevent and control the spread of infection.

Management oversight of the service had improved since the last inspection. The registered manager had implemented audits and checks to monitor the quality of care and ensure where issues were identified these were addressed.

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 8 October 2019) and there was a breach of Regulation 17 (Good Governance). 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 29 August 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 and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rupaal Care and Training Ltd 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.

Inspection carried out on 29 August 2019

During a routine inspection

About the service

Rupaal Care and Training Ltd is a domiciliary care agency providing the regulated activity of personal care to people living in their own home. The service was supporting people living with learning disabilities and older people some of whom were living with dementia. There were 17 people using the service at the time of the 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

The registered manager was clear about their role and understood quality and regulatory requirements. However, during this inspection we found that records were not always complete and that the service relied on the records provided by a sub-contracting agency to deliver care and support.

The service carried out a variety of checks to monitor the quality of care people received so that appropriate actions and learning could be taken forward to improve people's experiences. However, these were not always recorded.

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. However, the policies and systems in the service did not always support this practice.

People received care and support that was personalised and responsive to their health and care needs. However, care plans did not always contain enough information about the support the person required.

Despite some of the concerns we identified as part of this inspection, we found that people’s experience of the care and support that they received was positive and that the lack of appropriate records had not had a negative impact on the care they received.

People and relatives were happy with the care and support that they received from Rupaal Care and Training Ltd. They told us that they felt safe and reassured with the care staff that supported them.

People and relatives described care staff as “Kind”, “Caring” and “Nice.”

The service assessed risks associated with people’s health and care needs. These gave information to care staff about people’s identified risks and how to support people to reduce or mitigate those risks.

Care staff knew how to safeguard people from any form of possible abuse and the actions they would take to report their concerns.

Processes were in place to ensure that people received their medicines on time and as prescribed.

Staff recruitment processes involved the checking that all staff recruited were assessed as safe to work with vulnerable adults. People and relatives told us that staff were generally on time and that where they were running late they were always informed of this.

Care staff received an induction, regular training, supervision, appraisals and support which enabled them to carry out their role effectively. However, these were not always recorded.

People were supported with their nutrition and hydration where this was an identified need.

The service supported people to access health and care services where required.

Complaints were recorded, investigated and responded to according to the provider’s complaints policy.

During this inspection we identified a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around the management and governance of the service.

We have also made a recommendations about the following; the key principles of the MCA 2005 in relation to mental capacity assessments and recording best interest decisions.

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 23 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We wi

Inspection carried out on 21 December 2016

During a routine inspection

This inspection took place on 21 December 2016. We gave the provider two days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection.

At our last inspection in January 2016 the service was not meeting the standards in relation to the safe management of medicines, the proper assessment of risks, consent to care and treatment, quality assurance, staff recruitment and staff training.

After that inspection the registered manager sent us an action plan detailing how they would meet these standards. At this inspection we found that the service was now meeting these standards.

Rupaal Care and Training Ltd provide support and personal care to people living at home. There were 12 people using the service at the time of our inspection. The registered manager told us that eleven people were currently receiving personal care. The provision of personal care is regulated by the Care Quality Commission.

There was a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

People told us they were well treated by the staff and felt safe and trusted them.

The service was following appropriate recruitment procedures to make sure that only suitable staff were employed.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed. The registered manager carried out regular checks to make sure staff were administering medicines safely.

Staff offered choices to people as they were supporting them and people told us they felt involved in making decisions about their care.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely.

People told us that staff came at the time they were supposed to or they would phone to say they were running late.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities.

Staff told us that they were provided with a good level of training in the areas they needed in order to support people effectively which was confirmed by training records seen.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the assessment and planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff and the registered manager.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The agency had a number of quality monitoring systems including yearly surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.

Inspection carried out on 21 January 2016

During a routine inspection

We inspected Rupaal Care and Training on 21 January 2015. This was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. At our last inspection of this service in December 2013 we found one breach of the legal requirements. This was because the provider was not regularly or effectively monitoring the quality of service provided and this placed people at risk of unsafe or inappropriate care

Rupaal Care and Training is a domiciliary care service that provides support with personal care to people living in their own homes. At the time of our inspection the service was providing personal care to two adults.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

Risk assessments were completed by the local authority and not by the service. The service was not assessing the risks associated for people’s living environments. This meant people who used the service and staff were potentially at risk of accident and injuries. Staff were not suitably trained to administer medicines in line with legislation, guidance and as per the organisation’s medicines policy. The service did not have a robust recruitment process because there was not a recruitment policy in place and there were gaps in one staff member’s employment history.

Training was provided to staff but the systems in place to monitor and oversee it did not operate effectively. It was not clear if staff had the required knowledge or undertaken relevant training. We identified gaps in staff knowledge and understanding of the Mental Capacity Act 2005 (MCA). The provider did not act in accordance with the Mental Capacity Act 2005. Not all staff received on-going formal supervision.

There was not an effective system in place for ensuring that feedback from people and their representatives was in place and not all records were up to date.

People and their relatives told us that they felt safe and were supported by consistent staff who were caring. Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care. Staff had a good understanding of safeguarding adults and their responsibilities with regard to this

We found five breaches of 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 this report.

Inspection carried out on 3 December 2013

During a routine inspection

Rupaal provides support with personal care and domestic tasks to enable people to remain in their own homes. At the time of our visit a very small number of people were using the service. We saw that one person had completed a service evaluation with the assistance of their care manager. They had said that they were very happy with the service and with their carer.

People's care and welfare needs were being met. A care manager told us �it�s been a very successful care package so far.�

We found that people were treated with respect and their views taken into account when their care and support was provided. One person said in a service evaluation �my carer always includes me." People were provided with a safe service.

The provider ensured staff were given training and support to carry out their duties and effectively meet people's needs. A care manager told us �they have excellent standards of professionalism.�

The provider was not regularly or effectively monitoring the quality of service provided and this placed people at risk of unsafe or inappropriate care.