Archived: New Hope Care Rutland

New Hope Care Rutland is a domiciliary care service providing personal care to people living 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. At the time of our inspection there were 20 people receiving personal care.

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

Risks for people were not consistently assessed and planned for. There was a lack of information about how risks associated with people's needs might impact on the care being provided. Staff did not always respond to new risks or changes in people's needs in a timely manner.

The registered manager did not consistently have good oversight of the service. Quality checks took place, but these did not always identify where improvements were needed. The provider's own checks had not identified the shortfalls we found in risk management, medicine administration records and staff training.

Staff were recruited in line with the provider's policy, but improvement was needed to ensure they were sufficiently skilled and knowledgeable to meet people's individual needs. Staff turnover was high and some people felt this had an impact on the consistency of their care. People and relatives told us they received their medicines safely but staff did not always complete medicine administration records accurately. Staff used personal protective equipment effectively and safely. Staff understood how to protect people from abuse.

The registered manager had not always ensured we (CQC) were always informed about incidents we should be legally told about, although they had escalated incidents of concern to other safeguarding authorities.

People were not formally consulted or engaged in the development of the service. However, people and relatives felt the deputy manager was approachable and was committed to meeting people's needs.

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; overall the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was requires improvement (published 6 July 2022).

Why we inspected

We received concerns in relation to staff response to changes in people's care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Hope Care Rutland on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. You can see what action we have asked the provider to take at the end of this full report.

We have made a recommendation that the provider considers the current MCA legal framework where people experience fluctuating mental capacity.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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.

We have made a recommendation about staff communication to ensure staff can effectively communicate with people using the service.

Recruitment practices were mostly in place to ensure only suitable staff worked in the service, except where a reference from a previous care employer had not been obtained.

Staff training was not fully in place to cover people’s health conditions. The time frame of induction training was not always enough to ensure staff were able to fully understand people’s needs.

Timely calls mostly took place to provide personal care. The registered manager said she would review staff rotas to ensure there was adequate travelling time between care calls, so that calls would not be short or late.

Quality assurance systems were not fully in place to ensure people were provided with a quality service.

People were very satisfied with the care that staff provided and with the management of the agency.

People said safe care was provided, and they were protected against abuse, neglect and discrimination.

Details of risks to people's safety and how to reduce them were included in care plans.

Enough staff were employed to meet people’s needs.

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 told us they were treated with respect and dignity and staff had a caring and friendly approach to them. One relative said that staff were caring and friendly apart from one staff member. The registered manager said this issue would be followed up with the staff member concerned.

People said they had very good relationships with staff. Staff respected people’s privacy and encouraged them to maintain their independence and do as much for themselves as they wanted to.

Care plans reflected people's individual needs and preferences.

The registered manager understood their responsibilities. People and relatives were aware of how to approach the registered manager to raise concerns or complaints. They, and staff, were very complimentary of the registered manager and said the registered manager always listened to their views.

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

Why we inspected

This service was registered with us in December 2019 and this is the first inspection.

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.