Right at Home Chippenham

Updated 5 October 2021

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 Care Act 2014.

Inspection team

This inspection was undertaken by three inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

The service did not have a manager registered with the Care Quality Commission. A new manager started employment with the agency on 2 August 2021, but they had not started the process to be registered with us.

Notice of inspection

We gave a short period 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 2/08/21 and ended on 06/09/21. We visited the office location on 11/08/21.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke to eight people who used the service and two relatives. We spoke with members of staff in the office including the provider, manager and operations manager. We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at a variety of records relating to the management of the service, including policies and procedures, quality auditing and staff training. We spoke with seven more staff and contacted two professionals who have had recent contact with the service.

Updated 5 October 2021

About the service

Right at Home Wiltshire is a domiciliary care service that provides personal care to people in their own homes.

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 did not have a registered manager. This was a condition of their registration. A new manager had been appointed and commenced employment on 2 August 2021. There had been changes to the management team and office staff, which had given a period of instability. The provider had identified the service had slipped below their expected standards. A clear action plan was in place to address the shortfalls and time was being given to embed any changes.

Not all staff were up to date with their training, which was deemed mandatory by the provider. This did not ensure staff were up to date with their knowledge. Staff were not regularly having one to one meetings with their supervisor to gain support and reflect on their work. The provider and manager had plans to address these areas.

People felt safe with staff supporting them. Staff supported people to minimise risks they faced and reported any concerns about safety. People’s medicines were safely managed, and systems were in place to minimise the risk of infection. This included weekly testing of staff for COVID-19 and the safe use of personal protective clothing (PPE). There were enough staff to support existing care packages, although staff sickness and any self-isolation put pressure on the service.

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 were treated with kindness and compassion. People were complimentary about the staff and said they were caring, friendly and polite. Staff enjoyed supporting people and promoted their rights to privacy, dignity and independence.

People were happy with the support they received. They were generally supported by the same staff although their visits were not always on time. People had schedules of their visits, but these were not always accurate. The manager was re-visiting the scheduling of visits to ensure improvements were made. People had a support plan in place, which they helped devise. These were being transferred to the newly introduced electronic system, and reviewed to ensure more person centred information was recorded.

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 18/09/2019 and this is the first comprehensive inspection. A focused inspection of the service was undertaken on 17/09/20. At that time, the safe and well-led key questions were the only areas inspected, and an overall rating for the service was not given.

Why we inspected

This was a planned inspection based on inspection schedule.

We have found evidence that the provider needs to make improvements. Please see the effective, responsive and well-led key question sections of this full 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.