Royal Care Dover

Royal Care is a domiciliary care agency which provides personal care to people in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 the inspection 39 people were receiving a personal care service. People had a variety of health needs and some people had physical disabilities. The service provided support to people at the end of their life who wished to remain at home.

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

Risks to people’s health, safety and well-being were assessed, monitored and reviewed. There was guidance for staff about how to minimise risks. People received their medicines safely.

People were protected from the risks of abuse by staff who understood how to recognise the signs of abuse and how and where to report any concerns to. People told us they felt safe being supported by Royal Care staff. A person commented, “I have never felt unsafe or uncomfortable.” People were protected from the risks of infection by staff who were trained in infection prevention and control.

People were supported by a team of regular staff, who knew people well. People and their relatives told us staff arrived on time and completed everything they expected. People said staff were kind and caring and they were not rushed. They said their privacy and dignity were respected.

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.

Checks were completed to monitor the quality and safety of the service. The service continued to drive improvements. Staff performance and competency were monitored, and staff told us they felt valued and supported by the management team. People, staff and health care professionals were asked to provide feedback about the quality and safety of the service.

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 17 April 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.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 26 February 2020. 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 safe care and treatment.

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. 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 based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Royal 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.

Royal Care is a domiciliary care agency which provides personal care to people in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 the inspection seven people were receiving a personal care service. People had a variety of health needs and some people had physical disabilities. The service provided support to people at the end of their life who wished to remain at home.

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

Risks around people’s health was not consistently safe. Guidance was not available to staff for one person at risk of choking. Some people had other health needs which had not been robustly risk assessed. Although nobody had come to harm, this did not demonstrate effective management of people’s safety. Quality systems did not identify the concerns we found around managing risk. The provider took action in response to our concerns and sent us additional information after the inspection to tell us what improvements had been made.

People and relatives fed back positively about the staff and the calls they received. Staff were recruited safely. Staff used an on-call should they need any help or advice. People were protected from abuse and staff understood their responsibilities around reporting concerns. At the time of our inspection nobody was supported to take their medicines. People either took their own medicine or their relatives supported them. Accident and incidents were recorded and analysed to see what could change to prevent reoccurring events.

Peoples needs were assessed to ensure the service was able to support them well. People received care and support from trained staff. Most people did not require support with their meals and could either manage this alone or were supported by their relatives. 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 capacity was assessed as part of the assessment process and continually assessed.

People and relative’s spoke positively about the service. People felt their dignity and independence was respected. Relative’s and people told us they were asked for their views and involved in making decisions about their care.

People had care plans to inform staff of how care and support should be delivered in line with their needs. Staff and people accessed care plans using an online App. Care plans gave detailed information, were easy to use and easy to update. People were offered information in other formats such as large print should they need this. The service supported people at the end of their lives who wished to remain at home. Staff said they felt well trained and supported by the management team to care for people at the end of their lives. Complaints were responded to and managed appropriately.

People and their relatives said they felt well communicated with and had met the management team, the service worked in partnership with other healthcare professionals. Staff told us they were clear about their roles and what was expected of them. Audits were made on the service to check the quality of care people received. People, staff and other individuals were asked for feedback so positive changes could be made to the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 26 February 2019 and this was the first inspection.

Why we inspected

This was a planned inspection based on the services registration date.

Enforcement

We have identified a breach of Regulation in relation to management of risk at this inspection. 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.