Care and Respite England Ltd

Updated 18 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 24 March 2023 and ended on 18 April 2023. We visited the location’s office on 24 and 29 March, and 5 April 2023.

What we did before the inspection

Before the inspection we reviewed information we had received about the service since it registered with CQC. We reviewed CQC notifications. These describe events that happen in the service that the provider is legally required to tell us about.

The provider was not asked to complete a Provider Information Return (PIR) since before the previous inspection. We used the information the provider sent us in the previous PIR. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used this information to plan our inspection.

During the inspection

We spoke with 3 people who received personal care from the service. We also spoke with the relatives of 3 people about their experience of the care and support provided. We spoke with 3 members of staff, including the owner, who was also the registered manager, and support staff. We received feedback from one professional who worked with the service. Everyone’s comments have been incorporated into the report.

We looked at records relating to people's care and the running of the service. This included the care records of everyone who received personal care. We reviewed records relating to the management of the service, including staff files, policies and procedures, audits and quality assurance information.

We considered all of this information to help us to make a judgement about the service.

Updated 18 May 2023

Care and Respite England Ltd is a domiciliary care agency that provides personal care and support to people living in their own homes and flats. The service provides support to people with a range of physical, sensory or other health needs.

At the time of our inspection, 11 people were using the service, but only 6 people were receiving the regulated activity of 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

People and their relatives were positive about the staff who supported them. Staff were positive and motivated to deliver a good service. Staff knew people well and there was a supportive and family orientated culture.

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.

A small group of staff ensured people received consistent care which reflected individual needs and preferences. Improvements had been made to staff records and recruitment procedures since the last inspection.

Improvements had been made to the provider’s systems and processes to ensure people were kept safe from avoidable harm. Staff received training and incidents were reported and investigated as necessary.

Improvements had been made to ensure medicines were managed safely. An electronic recording system ensured records were completed accurately and meant people received medicines as prescribed.

Risk assessments were clearly recorded and up to date. This helped staff to identify, manage and reduce the risks involved in supporting people and provide safe and personalised support.

Quality assurance systems had been put in place to identify shortfalls and make ongoing improvements to the service. Audits had not been in place for long, but appeared to be comprehensive and would highlight concerns. We have made a recommendation about embedding quality assurance systems.

There had been improvements to the management of the service and people were generally positive about this. We have made a recommendation about management systems and processes.

Time and effort had been put into prioritising and implementing changes and improvements since the last CQC inspection. The provider was keen to learn lessons and develop the service for the benefit of people who used it, their relatives and staff.

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 January 2023) and there were breaches of regulations. We served the provider with a warning notice under Section 29 of the Health and Social Care Act 2008 because of failure to comply with regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulations and had met our recommendations. We have therefore withdrawn the warning notice.

Why we inspected

We carried out an announced inspection of this service on 12 and 20 October 2022. Breaches of legal requirements were found, and we served a warning notice in relation to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check the provider 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. 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 Care and Respite England Ltd on our website at www.cqc.org.uk.

Recommendations

We have made recommendations in relation to continuing to develop quality assurance systems and improve management processes at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.