We carried out a review of the data available to us about Rock of Ages Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rock of Ages Care, you can give feedback on this service.
Rock of Ages is a care agency providing personal care to people in their own homes. Some people receiving the care may have a long-term health condition or be living with dementia. At the time of our inspection there were 43 people receiving the regulated activity of personal care.
People’s experience of using this service and what we found
People told us they were happy with the care they received from the agency. They said staff were kind and caring and treated them with respect.
People said they felt safe in the hands of the carers. Staff knew them and they understood the type of care they required. People said they received the medicines they required and people’s medicines records had improved since our last inspection.
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 care plans included sufficient detail to help staff provide appropriate care. Staff said they never went to someone without knowing about them first and any changes to a person’s needs were updated in their care plans.
Staff said they had sufficient time with people and if they were running late, they would inform the office. People told us staff arrived when they were expecting them and stayed the time agreed.
People said staff wore appropriate personal protective equipment (PPE) and staff confirmed they had access to PPE when they needed it. We saw the registered manager led by example, wearing their mask throughout our visit to the office.
People were supported with their food and drink and told us staff always ensured they made their own choices in this respect. People were encouraged in their independence and staff supported people to go out if they could.
The agency was not providing care to anyone with an autistic person or anyone with a learning disability. However, we expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support: Model of care and setting maximises people’s choice, control and Independence;
People were encouraged to be independent and make choices around their care.
Right care: Care is person-centred and promotes people’s dignity, privacy and human rights; People were treated as an individual by staff and were provided with respect.
Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives;
Management and carers demonstrated a good ethos, one that was centred on the people they provided care to.
People told us they felt the agency was well managed and if they had any concerns or complaints they knew who to raise these with and they were responded to.
Staff were happy working for the agency. They told us they felt supported and listened to and they had the opportunity to express their views in staff meetings.
Learning took place from accidents, incidents and safeguarding concerns. Where important information needed sharing with staff, the registered manager held emergency meetings.
Since our last inspection, the registered manager had recruited additional office staff to help strengthened the governance arrangements within the agency.
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 (report published 24 October 2020).
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.
At this inspection we also found the provider had acted on the recommendation we had made to them around staffing.
Why we inspected
This inspection was prompted in part due to concerns received about people receiving safe and appropriate care. It was also prompted in part to follow up on action we told the provider to take at the last inspection.
We found no evidence during this inspection that people were at risk of harm. Please see the Safe key question of this full report.
The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rock of Ages Care on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Rock of Ages is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by the local authority. At the time of the inspection the service provided support for 14 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 provider had updated their medicines policy, but medicines were still not always managed safely. We made a recommendation to the provider to seek guidance on ensuring people received their calls in a timely way.
The provider had implemented new quality assurance systems and structures, but these were not always effective as the provider had not identified the concerns, we found in relation to medicines management, staff attendance and lateness.
Despite some concerns regarding lateness, people reported they felt safe with the staff who supported them. At our last inspection we made a recommendation in relation to the provider’s safeguarding procedures. At this inspection, improvements had been made. Each person had a risk assessment and these plans identified what action staff could take to mitigate potential risks.
Staff were provided with personal protective clothing and staff followed the providers infection control guidance. The provider had robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
The provider had updated their assessment processes and each person had a new care plan completed. There was information available throughout people's care plans which enabled staff to provide person centred care. People and their relatives had been involved in the care planning process. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff attended team meetings and they had regular supervisions and appraisals in line with the provider’s policy. People and their relatives spoke well of the registered manager and felt they were committed to delivering safe care and support.
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 rating at the last inspection (published 17 January 2019) was inadequate and there were multiple breaches of regulation. 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 some improvements had been made. However, we identified further improvements were needed in respect of managing medicines, and governance.
This service has been in Special Measures since 16 January 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a targeted inspection to check whether the provider had met the requirements of the Warning Notices in relation to regulations 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008. (Regulated Activities) 2014. When we were on site, we made the decision to carry out a focused inspection and look at Safe, Effective, Responsive and Well-led. This report only covers our findings in relation to these Key Questions.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance.
Please see the action we have told the provider to take at the end of this report.
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.
Rock of Ages is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by the local authority. At the time of the inspection the service provided support for approximately 30 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
The service was not managed in a safe way. People’s medicines were not administered or managed correctly. The provider had failed to ensure there were safe robust recruitment procedures in place to safely recruit staff.
We recommended the provider seek and implement national guidance in relation to safeguarding adults as the registered manager was not always able to evidence how safeguarding concern had been investigated.
Risk management plans were not detailed and did not always give staff clear guidance to mitigate risks. People were not always notified when care workers were running late.
The provider carried out pre-admission assessments, but they were not comprehensive and lacked important information on people’s physical health needs.
Care planning was not person centred and lacked information that was important to people. People's end of life wishes were not always documented appropriately and the registered manager agreed to update people’s care plans.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems
in the service did not always support this practice.
Quality assurance processes were ineffective. There were no auditing systems in place and the provider did not have good oversight of the day to day running of the service.
Most people were happy with the care they received, and they felt care workers were kind and helpful. People's privacy was respected, and their dignity encouraged and maintained. People and their relatives told us staff encouraged them to remain as independent as possible.
Staff understood how to prevent the spread of infection by using protective clothing such as aprons and gloves.
People understood how to make a complaint and told us they felt comfortable raising concerns with the registered manager. The provider however did not keep a clear audit trail about how complaints were managed and handled.
The service worked in partnership with healthcare professionals and families to ensure people's health care needs were met.
Rating at last inspection
This service was registered on 27 December 2018 and this was the first inspection.
Why we inspected
This was a planned inspection based on the date of registration.
Enforcement
We have identified breaches in relation to safety, staff recruitment, staffing levels, consent, staff training, dignity and respect and leadership and governance. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This
means we will keep the service under review and, if we do not propose to cancel the provider's registration,
we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of
inadequate for any key question or overall rating, we will take action in line with our enforcement
procedures. This will mean we will begin the process of preventing the provider from operating this service.
This will usually lead to cancellation of their registration or to varying the conditions of the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than
12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as
inadequate for any of the five key questions it will no longer be in special measures.