Right at Home (Sefton)

Updated 22 November 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 was 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.

This inspection took place on 18 and 19 September 2018. The provider was given 48 hours' notice of our visit because we wanted to ensure the registered manager was available to support the inspection process.

The inspection was undertaken by two inspectors on the first day; one inspector on the second day and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service; the Expert by Experience carried out telephone interviews to people who used the service and relatives where appropriate.

Before the inspection we reviewed records held by CQC which included notifications and any safeguarding concerns. A notification is information about important events which the registered person is required to send us by law.

Before the inspection we received a completed Provider Information Return (PIR). This document gave the registered provider the opportunity to tell us about how the service delivers safe, effective, compassionate and high-quality care to people and what plans they have in place to continue to make improvements to the service. We also contacted the local authority commissioning team to ask for their views. We used all this information to plan how the inspection was conducted.

During the inspection we visited the agency’s office and looked at a selection of records and documents relating to the service. This included, assessments of risk and care planning documents for five people, medicines records, complaints, audits, governance records, as well as policies and procedures. We looked at the recruitment records of four staff members and the current staffing rotas.

During the inspection we met and spoke with the registered manager, deputy manager, group quality and compliance manager and two directors of the service. We also met and spoke with five staff (carers) and we visited a person who was receiving a service from the agency. As part of the inspection we carried out telephone interviews with six staff, seven people who used the service and 14 relatives. We also received feedback from a further three community-based health professionals

Updated 22 November 2018

The inspection took place on 18 and 19 September 2018 and was announced.

This was the first inspection of Right at Home (Sefton) since it was registered in August 2017.

Right at Home South Sefton operates as a franchise of Right at Home UK. It provides care and support to people in their own homes including; companionship, home help and personal care. This report focuses on the experiences of people who received personal care as part of their support package. Most of the people who use the service are older people, some of whom are living with dementia.

Right at Home (Sefton) was providing a service to 61 people at the time of our inspection. There were 49 people receiving the regulated activity of personal care. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.

The service had a registered manager in place at the time of the inspection.

A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The management team led by example and their passion and commitment to the service was evidenced through very good feedback from people who used the service, relatives, staff and their robust arrangements for monitoring and delivering a quality service. During this inspection, we found multiple examples to demonstrate the how the management team and staff team were passionate about providing an innovative service which focused on good standards of care. People and relatives used words such as, "Excellent", "First class", "Brilliant" and "Superb" to describe the agency. The registered manager was described as, "Very caring, "Supportive" and "Professional."

People received personalised care which was responsive to people’s needs and wishes. Staff were very knowledgeable regarding people’s support and displayed a good understanding of how people communicated and wished to be treated in their own home.

The agency had an flexible approach to be providing a service based on people’s individual needs and requirements. This include last minute changes to the staffing rotas to accommodate people’s wishes.

People and relatives spoke highly regarding the caring, polite, respectful and empathetic attitude of the staff. They said the staff went above what was expected of them. This view was also shared by relatives.

The staff team worked very closely with people and relatives to support them when facing emotional times and dealing with sensitive issues. Their understanding and kind approach was evident when talking with them. We saw this particularly around supporting people with their wishes around end of life care.

The registered manager ensured a consistent staff team to support people in their own home. It was evident that true friendships had been forged by having the same staff in attendance. People and relatives told us how much this meant to them and the difference it made.

People were much encouraged to have maximum choice and control of their lives and were fully involved with decisions about their support. Their consent was sought around day-to-day decisions and they were fully involved in any changes made.

People had a plan of care which was centred around their individual support needs. This included plenty of information about their routines, likes, dislikes, preferences and choices to enable staff to deliver this how they wished.

We saw very good liaison with community based professionals to support people in their own home to support people’s health needs and maximise their independence. Feedback from community health professionals was very positive and it was evident they held the agency in high regard. Links with other organisations had been established to support people with their needs. For example, dementia groups, community health teams and the ambulance service.

People were fully supported to follow their chosen interests and maintain relationships with relatives and friends that mattered to them.

People had a wide range of opportunities to provide feedback on the care provided by the agency. This included satisfaction meetings and visits to people in their own home. People’s views were paramount to the continuous improvement of the agency.

People had access to a complaints procedure. Complaints received were logged, investigated and responded to. No one at the time of the inspection raised any concerns, all the feedback we received was very positive.

Staff told us how much they enjoyed working for the agency and that they felt very well supported by the registered manager. The registered provider had introduced a number of schemes to recognise and reward staff who had been complimented by people receiving support. Staff told us they felt proud to work for the agency.

Staff received training which provided them with the skills and expertise to undertake their work safely. This included more specific training to meet more complex conditions and opportunities for staff development. New staff received a comprehensive induction training programme to support them; this included a period of shadowing a more experience member of staff before working independently. Staff told us the training programme was good.

Risks to people were identified during an initial assessment and control measures were put in place to minimise these risks to provide safe care.

There was an open culture which people and staff were encouraged to speak up if they had concerns. Staff had received training in the protection of adults and knew what action they should take if they suspected or witnessed abuse.

The provider understood the legal requirements of the Mental Capacity Act 2005 (MCA) and took the necessary action if they had concerns about people's capacity.

Staff members we spoke with fully understood the importance of acknowledging people’s diversity, treating people equally and ensure that they promoted people’s rights. We saw people’s ethnicity, spiritual needs and sexual orientation were recorded in their support plans.

Staff had been recruited safely to ensure they were suitable to work with vulnerable people.

People who required support with their medicines received them safely and the staff had completed training in the safe administration of medicines, which included observations and competency assessments. Medicine audits were completed to look at errors and lessen the risk of re-occurrence.

We saw that people were supported to access advocacy services. Advocates are trained professionals who support, enable and empower people to speak up.

Further information is in the detailed findings below.