Cheshire Rural Care

Updated 16 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Prior to the inspection we contacted the local authority commissioning team to seek their views about the service. They raised no concerns about the care and support people received. We also considered information we held about the service, such as notification of events and incidents which occurred at the service which the registered provider is required by law to send to CQC. Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This is a form that we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan how the inspection should be conducted.

The inspection was carried out by an adult social care inspector. The registered provider was given 24 hours’ notice before our site visit and advised of our plans to carry out a comprehensive inspection of the service. This is because the location provides a domiciliary care service to a small number of people and we needed to be sure that someone would be in the office to assist with the inspection.

As part of the inspection we visited the office and met with the registered provider and manager for the organisation. We spoke with five people who used the service and four relatives on the telephone. We spoke to three members of care staff. We also looked at three care plans for people who used the service, three staff personnel files, MAR records for four people, staff training and development records as well as information about the management and quality assurance systems at the service.

Updated 16 June 2018

This inspection of Cheshire Rural Care took place on 22 May 2018. The provider was given 24 hours’ notice. This was because the service provided a domiciliary care service and we needed to be sure that someone would be available to assist with our inspection.

Cheshire Rural Care provides personal care to adults living in Cheshire. The service had registered with the CQC on the 27 March 2013 but had previously operated from a different location and moved to its current location in April 2016. This was the first inspection of Cheshire Rural Care. At the time of our inspection, the service was providing personal care to 13 people living in their own homes in the community.

There was a registered manager in post at the service who was also the registered provider of the service. The registered manager was supported by a manager of the service. The two managers shared responsibilities among themselves for the running of the service, with the manager being responsible for paperwork and business matters and the registered manager adopting a more ‘hands on’ approach, responsible for overseeing care related duties. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

All of the people we spoke with who used the service told us they felt safe when receiving care and support from the staff at Cheshire Rural Care. People enjoyed continuity of support from a familiar staff team which promoted a sense of security. People told us they felt comfortable in the company of staff and described staff as ‘excellent’, ‘trustworthy’ and ‘brilliant’.

Staff rotas showed there was an adequate number of staff employed to meet the needs of the 13 people who used the service. Staff had received training in safeguarding, understood how to recognise abuse and how to report concerns or allegations.

Safe recruitment procedures were in place to ensure that staff appointed were suitable to work with vulnerable people. This included pre-employment checks such as a satisfactory DBS check and two references.

The majority of people who used the service managed their own medication but received prompts and reminders from staff. People told us they were happy with the support they received with their medication and staff had received the relevant medication training to administer this where required.

Risks to people’s health, safety and welfare were considered and information was available to guide staff on how to support people safely. Environmental assessments were completed to ensure that staff worked in a safe environment. The registered provider maintained a record of accidents and incidents which occurred at the service and appropriate action was taken to prevent the risk of re-occurrence.

Staff received training to ensure they had the skills and knowledge to support people effectively. Staff received supervision and an annual appraisal and told us they also felt confident to raise any issues or support needs informally.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service operated within the principles of the Mental Capacity Act 2005 (MCA). People told us that consent was sought and staff offered them choice before providing care. Staff understood their role in enabling and empowering people to do tasks for themselves where able.

People's overall health and well-being needs were effectively supported because staff maintained good communication within the team and with outside partner agencies where appropriate. People were supported to have a varied diet and maintain their hydration levels and this was clearly recorded within the daily records.

Staff had a good knowledge of people’s individual needs and had formed positive relationships with people and their families. People told us staff were friendly and genuine towards them. One person told us, “Each and every one of them is so kind, they are true carers.” We reviewed written compliments from people who used the service which commended staff on their kind approach and for ‘going the extra mile.’

The caring culture extended throughout the service and was promoted by the registered provider who prided themselves on their inclusive and informal approach which resulted in a ‘family feel’ to the service. One member of staff told us, “It’s a small service; they [management team] are considerate and treat you like a friend as well as a member of staff.”

The registered provider, manager and staff had a good knowledge of people, their individual likes and dislikes and social backgrounds. This enabled them to provide support in a person-centred way based on people’s preferences. The registered provider had plans to further develop the documentation to ensure this level of detail was reflected in the written records.

A complaints procedure was in place and details of how to make a complaint had been provided to people who used the service. People and relatives spoken with told us they had no reason to make a complaint, but in the event that they did, they trusted that these would be responded to.

The registered provider had a number of different systems in place to assess and monitor the quality of the service, ensuring that people were receiving safe, compassionate and effective care. This included regular audits of areas such as medication, care plans, daily records and spot checks.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred at the service in accordance with our statutory requirements. This meant that CQC were able to monitor risks and information regarding the service.

Further information is in the detailed findings below.