4 and 5 March 2015
During a routine inspection
This was an announced inspection which took place on 4th and 5th March 2015. We had previously carried out an inspection in November 2013 when we found the service was meeting all the regulations we reviewed.
Ribble Homecare is registered to provide personal care to people living in their own homes. At the time of our inspection there were 15 people using the service.
The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.
We identified seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to breaches of the 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.
People told us they felt safe with the staff who supported them and that there were sufficient staff to meet their needs. They told us staff would always stay for the right amount of time and did not appear rushed. However, we found recruitment processes in the service did not protect people from the risk of staff who were unsuitable to work with vulnerable people. Staff had also not received all of the training they needed to ensure they were able to deliver effective care.
The systems in place to manage the way medicines were administered to people who used the service were not sufficiently robust to ensure people always received their medicines as prescribed.
Risk assessments had not been completed in relation to people’s individual needs. Care records contained limited information for staff to follow to help ensure they provided safe and effective care to people who used the service.
People who used the service told us they could make choices about the support they received. However we found the registered manager did not have a good understanding of the principles of the Mental Capacity Act (MCA) 20015. This meant the systems in place to record whether people were able to consent to the support they needed were not sufficiently robust to ensure people’s rights were protected. Staff were also confused about the rights of people to make their own decisions.
People made positive comments about the attitude and approach of staff. They told us staff were always kind, respectful and considerate. We also saw positive comments in the feedback forms people had completed regarding their experience of the service. However, we noted care records contained limited information about people’s life histories or the care they would like to receive at the end of their life. We have made a recommendation about the planning and delivery of end of life care.
All the people we spoke with told us the care provided by the service was responsive to their needs. The registered manager was in regular contact with all the people who used the service and was able to quickly respond to any comments or suggestions from people about the care they received.
Staff told us they were happy working in the service. They told us the registered manager was approachable and always available to provide any support or advice they required.
There were systems in place to record any complaints about the service and all the people we spoke with told us they would be confident to approach the registered manager with any concerns.
Although the registered manager was completing regular ‘spot checks’ regarding the quality of care staff were providing, there were no other quality assurance systems in place. This had resulted in many of the shortfalls identified during the inspection.