Roche Homecare (Community)

Updated 12 January 2024

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team was made up of 2 inspectors and 1 regulatory coordinator.

Service and service type

Roche Homecare is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

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

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

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 reviewed information we had received about the service since the last inspection.

During the inspection

We spoke with 7 people about their experience of the care provided and 2 relatives. We spoke with the nominated individual, registered manager, and 6 members of staff.

We looked at written records, which included 6 people’s care records and 7 staff files. A variety of records relating to medicines and the management of the service were also reviewed.

Updated 12 January 2024

About the service

Roche Homecare is a domiciliary care agency providing support and personal care to people in their own homes. The service provides support to adults who have a range of physical, cognitive, or mental health needs. At the time of the inspection, the provider told us 76 people were receiving support with personal care from the service.

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

The providers quality assurance and governance systems in place to assess, monitor, and improve the quality and safety of the services provided had failed to identify the issues we found during this inspection. The provider had not ensured all staff were appropriately trained and received regular supervision to support their learning and development. People and their relatives knew how to complain however, not all complaints had been recorded to show what actions had been taken.

Risk assessments did not always include information about specific risks, were not detailed and some risk assessments had not been completed. Medicines were not always managed safely. Staff did not always record when topical medicines such as creams were given, and time specific medication was not always given correctly.

Staffing levels were sufficient to meet people's needs however, staff were not always recruited safely due to pre-employment checks not being satisfactory and gaps in employment not being recorded. We made a recommendation about safe recruitment within the service.

Systems were in place to safeguard people from the risk of abuse and people said they felt safe. Incidents and accidents were reported, investigated and measures taken to mitigate future occurrences. However, we did identify one incident which was not reported to CQC.

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 and their relatives told us they felt safe and were mainly happy with the support they received. Most people and their relatives told us they were engaged and involved in the service and asked for their feedback.

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 good (published 25 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to the management oversight, medicines, and risk at this inspection. We have made a recommendation about the provider's recruitment systems.

Please see what action we have told the provider to take at the end of this report.

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.