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Inspection Summary


Overall summary & rating

Good

Updated 11 November 2017

This inspection took place on 28 September 2017 and was announced. The provider was given notice because the location provides domiciliary care services and we needed to be sure that someone would be available to answer our questions and assist with the inspection. We contacted people who used the service by telephone on 4 October 2017 and staff on 9 October 2017 to ask their views.

Ryedale Homecare is based in Malton and provides personal care to people in their own homes within Malton and surrounding areas. The service was registered with CQC in October 2012.

At the time of inspection 56 older people used the service, some of whom were living with dementia. The director, who was the registered manager, was present throughout the 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 2008 and associated Regulations about how the service is run.

At the last comprehensive inspection in September 2016, we identified breaches of regulations. The registered provider had failed to keep accurate records of medicines that were administered. They had not completed appropriate recruitment checks before new staff were employed at the service and had not ensured completed and accurate records were maintained. The service was rated at that time as requires improvement overall. The registered provider wrote to us telling us what action they would be taking in relation to the breaches of regulation.

At this inspection, we found the provider had implemented their action plan and met all requirements within the regulations.

Robust recruitment procedures were now in place. We found that appropriate checks had been completed before new staff commenced employment. Staff recruitment records contained full employment histories and gaps in employment had been explored. References had been obtained and there was clear recorded evidence of interviews taking place.

Clear procedures were now in place to guide staff on the safe administration of medicines and staff had received medicines training. Records showed that people had received their medicines as prescribed. Where gaps in records had been identified, appropriate action had been taken. The manager had worked hard to improve quality assurance processes that were in place and now carried out a number of quality assurance checks to monitor and improve the standards of the service. Action had been taken when concerns were found.

Records showed risks were well managed through individual risk assessments that identified potential issues and provided staff with information to help them mitigate risks, while supporting people to maintain their independence. These had been regularly updated to reflect current needs.

There were systems and processes in place to protect people from the risk of harm. Staff we spoke with were all aware of the different types of abuse, what would constitute poor practice and what actions needed to be taken to report any concerns.

New staff completed an induction before they began working in the community. There were systems now in place that ensured staff received the training and experience they required to carry out their roles. Staff performance was monitored and recorded through a regular system of supervision and competency assessment.

Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005. Staff were aware of the procedure to follow if they suspected a person lacked capacity to make decisions. Signed consent had been sought where possible.

Some people were supported by staff with meal preparation. Records and people confirmed that they were given choice and appropriate support was provided in this area.

Care records contained evidence of close working relationships with ot

Inspection areas

Safe

Good

Updated 11 November 2017

The service was safe.

Staff could explain indicators of abuse and the action they would take to ensure people’s safety was maintained.

Robust recruitment procedures were in place. Appropriate checks had been completed before new staff commenced employment.

Procedures were in place to guide staff on the safe administration of medicines and staff had received medicines training.

Risk assessments were in place and were specific to people’s needs and their home environment.

Effective

Good

Updated 11 November 2017

The service was effective.

Staff performance was monitored and recorded through a regular system of supervision and competency assessment.

Staff completed a thorough induction to the service. Staff had completed mandatory and specialist training.

Staff demonstrated good knowledge of the Mental Capacity Act 2005. Where possible, consent to care and support had been recorded.

People were supported to maintain their nutritional wellbeing.

Caring

Good

Updated 11 November 2017

The service was caring.

People were treated with kindness and compassion. Staff promoted people’s dignity and privacy when delivering care.

People told us they had choice and control over their care and support and made decisions about how their needs were met.

People were supported by a regular team of staff who were knowledgeable about their likes, dislikes and preferences. Positive relationships had been developed.

Responsive

Good

Updated 11 November 2017

The service was responsive.

Care plans focused on each person as an individual and the support they required to maintain their independence.

People, and where appropriate their relatives, were actively involved in care planning and decision making.

There was a complaints procedure in place. People told us they did not have any concerns about the service, but said they were very confident that any issues they raised would be acted on.

Well-led

Good

Updated 11 November 2017

The service was well-led.

The registered manager had worked hard to improve quality assurance processes that were in place and now carried out a number of quality assurance checks to monitor and improve the standards of the service. Action had been taken when concerns were found.

People who used the service and the staff were enabled to provide feedback.

Regular staff meetings had not always taken place but plans were in place to improve this. Staff told us they were well supported and the management team were approachable.