Background to this inspection
Updated
4 September 2019
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 carried out by one inspector and one Expect by Experience who supported the inspector by contacting people by telephone to request feedback. 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 homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ 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 31 July 2019 and ended on 7 August 2019. We visited the office location on 31 July 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the action plan submitted by the provider following the last inspection. We sought feedback from the local authority and professionals who work with the service. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke briefly with one person who used the service and four relatives about their experience of the care provided. We spoke with 13 members of staff including the nominated individual, registered manager, care co-ordinator, senior care workers and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We received feedback from four professionals with regular contact with the service.
Updated
4 September 2019
About the service
Rivendell Care and Support is a domiciliary care agency providing personal care to 25 people living in their own homes, some living with dementia, physical and learning disabilities.
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.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and coordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Staff were kind, compassionate and caring. The service promoted people's dignity, privacy and independence.
Risks associated with people's care had been assessed and guidance was in place for staff to follow.
Medicines were managed safely.
People were supported by enough staff who had been safely recruited.
Care plans were detailed, person centred and evidenced that people and their relatives were consulted around their care preferences.
Staff received appropriate induction, training and support and applied learning effectively in line with best practice. This led to good outcomes for people and supported a good quality of life.
Improvements made following the last inspection had been sustained and embedded. There were quality monitoring systems and processes in place to identify how the service was performing and where improvements were required.
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.
Staff supported people to meet their health and nutritional needs. People were supported and encouraged to maintain their independence. Staff worked with health care professionals to maintain people's wellbeing.
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 September 2018) and there were two breaches of regulation. 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
This was a planned inspection based on the previous rating.
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.