Real Care Solutions

Updated 14 December 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 who was also the provider.

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 the registered manager would be in the office to support the inspection.

Inspection activity started on 10 October 2023 and ended on 06 November 2023. We visited the location’s office on 10 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We reviewed information gathered as part of monitoring activity that took place on 18 July 2023 to help plan the inspection and inform our judgements. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people and/or their relatives, 6 staff including the registered manager, who is also the provider, the office manager, the care coordinator and 3 care staff. We looked at the care documentation for 6 people and records relating to the management of the service including policies, staff recruitment and training records and systems used to monitor the quality of the service.

Updated 14 December 2023

About the service

Real Care Solutions Limited is a domiciliary care agency providing care to people in their own homes. It aimed to provide personal care to older and younger adults, autistic people, people with a learning disability, people living with dementia or a with sensory impairment. . At the time of the inspection there were 18 people using the service, 17 of whom received support with 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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not provide personal care to anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff understanding of the principles of the Mental Capacity Act 2005 (MCA) was not strong. There were occasions where these principles had not been applied when choosing to override a person’s decisions about their care.

Staff were passionate about putting people at the centre of their care and recognised the importance of working with them in a way that maintained their independence. People and their relatives said staff really got to know them well, and always tried to do what they could to brighten their day.

Right Care:

Staff did not receive sufficient training to ensure people received the right care in relation to all their needs. However, people and their relatives were complimentary towards the staff and the care they received which they said was kind, caring and considerate. There were enough staff to meet people’s needs so people felt well cared for and never rushed.

Right Culture:

The provider did not have robust systems in place to manage and monitor the quality of the service and to ensure continuous improvements were made. They had not kept up to date with current good practice guidance and regulatory requirements. They were not aware of their responsibilities in this regard, or of the requirement to notify the Care Quality Commission of certain events that took place.

In many ways the provider tried to promote a person-centred culture and worked to provide care to people that made a positive difference to their lives. However, the lack of robust oversight did not always support them to achieve this. People, relatives, and staff all said the management team were approachable, supportive and listened to their views.

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 5 September 2017). The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Why we inspected

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

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

Enforcement

We have identified breaches in relation to safeguarding people from avoidable harm, staff training, consent, and management oversight of the service.

Please see the 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.