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Right at Home Solent

Overall: Outstanding read more about inspection ratings

54b High Street, Fareham, PO16 7BG (01329) 233755

Provided and run by:
Amkare Limited

Report from 21 November 2023 assessment

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Safe

Good

Updated 11 January 2024

People felt safe and protected from the risk of harm and abuse. The provider assessed risks to ensure people were safe. People were involved in this process and staff had an exceptional understanding of how to monitor and mitigate these risks. There were sufficient, safely recruited staff who visited people at the times they expected. A variety of training was delivered for staff, so they had an in depth understanding of people’s needs.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Learning culture

Score: 3

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safe systems, pathways and transitions

Score: 3

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safeguarding

Score: 3

The provider had a robust safeguarding policy in place. Effective processes ensured safeguarding concerns were thoroughly investigated and raised with the local safeguarding team and CQC. The provider worked in an open and collaborative way with these agencies to ensure good, joined up work. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We found the service was working within the principles of the MCA. Where people were unable to make decisions for themselves, Mental Capacity Assessments had been completed and where necessary, decisions were made on behalf of people in consultation with appropriate others in people's best interests.

People and their relatives told us they felt safe with the support they received from staff. For example, one person told us, “I’m feeling very safe with the carers visiting me. They give me more confidence.”

Staff had received safeguarding training and had a good understanding of how to recognise and act on safeguarding concerns. All staff felt the management team would take concerns seriously and take appropriate action. One staff member told us that when they needed to raise a safeguarding concern, they “could not believe how amazing they [management team] were and what quick action they took.”

Involving people to manage risks

Score: 3

An effective system was in place to ensure staff had up to date information about people and staff could let the office staff know if there were any changes with people’s needs. We found some risk assessments were not in place where we would have expected them to be. Although this did not have a negative impact on how people were supported, we were concerned this could increase the risk of harm if unfamiliar staff needed to deal with an emergency situation. The provider implemented these risk assessments promptly and assured us they would improve their processes to ensure risk assessments were always in place when needed.

People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. People and their relatives provided positive feedback about the way their risks were managed. For example, a relative told us, “The carers really do care and know the limits of what my relative can do. For example, he can’t deal with hot water. They have done all the risk assessments in the care package so he’s safe.” People also told us they were involved in how their risks were managed. A person said, “I have my say in how I want my care to be conducted via a care plan which is reviewed regularly.” People and relatives were particularly complimentary about how well staff knew people and understood their needs. A relative told us,” [Staff member] saved my relatives life on two occasions by spotting [a change in health condition]”. “I as a relative, am blown away by the level of commitment.”

Staff were exceptionally knowledgeable about the risks associated with people’s support needs and health conditions. They demonstrated they knew people very well and had a thorough understanding of how to reduce risks for people while ensuring this was done in the least restrictive way possible.

Safe environments

Score: 3

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safe and effective staffing

Score: 3

Staff told us there was enough staff to support people safely. They felt they could get to people on time and were not rushed. Staff were glad they supported the same people on a regular basis. For example, one staff member said, “I know [Person’s name] very well so can see when she deteriorates and starts struggling with things.” Staff were highly complementary about their training and felt they had the right skills to carry out their role effectively. Staff said they received thorough inductions with the opportunity to shadow more experienced staff. One care worker said it was the best induction they had ever received. A team leader told us all staff completed core training and then undertook more bespoke training depending on the needs of the people they were supporting. We were told of numerous examples of staff and leaders working collaboratively and creatively with people, their relatives and health professionals external to the service to understand the support required for a people. Staff told us they received excellent support from the leaders and could go to them at any time if needed. A care worker also told us about a weekly welfare call that had been implemented and explained how much it helped their well-being. We saw from a staff survey that 89 percent of staff felt they were supported to develop. Leaders provided us with some case studies which demonstrated how staff had been supported to progress.

Most people told us they received good continuity of care. This meant people received care from staff who understood their needs and preferences, and people were extremely positive about the relationships they developed. For example, one person said, “I get the carers I’m familiar with and that enhances my wellbeing.” Some people and their relatives felt continuity could be better, particularly when there was sickness or holidays. People and relatives felt staff arrived when they expected them to and stayed for the correct length of time. People and relatives told us they were supported by staff who were competent and had the right skills to support them safely. One relative said, “I wouldn’t even need to question their training standards, they are just right for the job in hand.” Another said, “My relative has multiple health problems, but the carers have learned a great deal about her and have delivered the right care. Without their support she would be in a care home.”

The provider had effective processes in place to ensure people received care from staff who had the time, skills, and experience to do so safely and effectively. Staff were recruited safely and there were enough staff deployed to meet people's needs. The provider involved people in the recruitment of staff and carried out a process where staff were matched to people depending on factors such as their likes, life experiences and personalities. The provider worked hard to ensure people received care from a consistent group of carers and in the main, achieved this. They were aware this could not always be achieved when staff were sick or on holiday and told us they were reviewing their processes so they could improve in this area. The provider went out of their way to ensure staff had the right knowledge about the needs of people and how to support them. They involved people, their relatives and contacted specialists in the area of support needed. This meant staff had a very good understanding of people’s needs and how they liked to be supported.

Infection prevention and control

Score: 3

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Medicines optimisation

Score: 3

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.