Rainbow Care Solutions (Staffordshire)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People told us they felt safe. However, risk assessments were not always in place to guide staff how to manage clinical risks. Where risk assessments were in place, they provided clear and thorough guidance for staff. People were supported by staff who were recruited safely and well trained. People and relatives told us there was a language barrier with some staff which impacted communication and understanding but spoke positively regarding the general standard of care provided. The learning culture was positive and the registered manager was proactive in implementing competency checks and staff supervision if needed to improve the care provided by staff. People and relatives found the management team to be approachable. However, where people had raised concerns, we received some mixed feedback regarding whether sufficient action was always taken to reduce the risk of reoccurrence. Staff felt well supported by the registered manager and provider and felt they were given adequate opportunity to improve their learning.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

A positive learning culture was evident which was disseminated from the registered manager through to staff. When something went wrong, this was shared with staff through supervision or team meetings to reduce the risk of any reoccurrence. An accidents and incidents policy was in place which was followed. Accidents and incidents were recorded and investigated. Accidents and incidents records showed evidence of action taken and learning shared with staff. There was evidence of trends analysis being undertaken to identify patterns so the provider and staff could learn further. A complaints policy was in place that was followed.

People told us they felt supported to manage risks. One person told us, “The staff do know me well. I can’t complain about that, they are really friendly and do their jobs properly.” People and relatives were comfortable in raising concerns. They told us they raised any concerns with the management team at the local office. One relative told us, “I would be confident in contacting the office and they would respond.” Relatives told us the provider was proactive in addressing any concerns. One relative told us, “I have not really had to contact the office as they will come out and sort any issues anyway.” Where people had raised concerns, we received mixed feedback regarding whether sufficient action had been taken to learn from this and reduce the risk of reoccurrence. For example, one relative told us there had been repeated incidents related to a person’s property being left unsecure and another told us their care preferences were not always met despite this being shared with the provider.

Staff were comfortable in raising any concerns and were confident that the registered manager would address any safety concerns. One staff member told us, “The management team at the office are perfect. If it was a percentage, I would give 101%”. Staff told us they had supervisions where they discussed how they could improve the care provided to people. One staff member told us, “The registered manager does 1:1 supervision if there are things they need to put right. They will give more training if needed. There must be training after every supervision to make sure you get it right.” The registered manager told us they encouraged staff to share any concerns so they could be addressed, and this was corroborated by staff. The registered manager was open and honest throughout the assessment process and acknowledged where improvements could be made. Where concerns were identified, the registered manager was proactive in responding and took action to address any feedback we gave them.

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.

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

Staff told us there was sufficient guidance in people’s care plans and risk assessments to enable them to manage risk to people. One staff member told us, “Risk assessments are in place to guide us, it’s all written in the app”. Staff told us about how they managed risk to people including following risk assessments, wearing appropriate Personal Protective Equipment (PPE) and complying with food hygiene standards. Staff were knowledgeable regarding moving and handling and told us there were always 2 staff members on calls where people required support with hoisting as per their risk assessments. Staff gave examples of where they had identified concerns regarding people’s health and had escalated this to medical professionals in line with people’s risk assessments. Despite risk assessments not being in place initially regarding some clinical conditions such as diabetes, most staff knew what symptoms to look for and told us how they would escalate concerns. The registered manager acknowledged gaps we had identified in risk assessments and provided evidence of these risk assessments being completed. The registered manager also confirmed an internal audit had been undertaken to ensure any gaps in risk assessments had been identified. The registered manager told us a thorough assessment was undertaken prior to the start of any care package, involving both people and their relatives, which included a full assessment of identified risks. The registered manager told us risk assessments were regularly reviewed and additional reviews were undertaken if needed due to changes in a person’s needs or risks. The registered manager told us they encouraged staff to raise any concerns so risks could be reviewed and action taken to mitigate risk to people. The registered manager told us they were aware of 2 security breaches and they showed evidence of action taken to address this through having a meeting with all staff and reiterating relevant policies.

People told us staff managed their risks safely. One person told us, “I do feel safe with the care provided, nothing has ever happened to place me at risk.” Where people were supported with mobility, they told us staff made them feel comfortable and safe and followed their care plans and risk assessments. One person told us, “Staff support me with hoisting. I feel safe as they know how to use it. They always send 2 carers out when they use the hoist.” People told us they were involved in their care, but they had not always seen their own risk assessments. People did not always find staff sufficiently knowledgeable in respect to specific medical conditions and clinical needs. People and relatives told us staff had identified where there had been health concerns and had escalated and sought medical attention when needed.

A risk management policy was in place which was followed in most circumstances. Risk assessments were not always in place for the management of clinical conditions such as epilepsy or diabetes which meant the provider could not be assured staff knew how to manage these risks. We raised this with the registered manager who immediately reviewed people’s records and implemented risk assessments for clinical conditions. Where risk assessments were in place, they provided clear guidance for staff regarding how to manage and mitigate risk to people. Care plans and risk assessments in place were person centred and individualised. Risk assessments were proportionate and guided staff to ensure people had choice regarding their care. The provider engaged positively throughout the site visit. The provider was proactive and took immediate action following the site visit to update any documentation and address any actions identified including implementing additional risk assessments and updating care plans.

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

People told us they rarely had late and missed calls. However, they told us that when they did, they were not always contacted by the provider. People provided positive feedback regarding staff knowledge and training. One person told us, “Staff have had enough training, they definitely do their job properly. They do it all exactly how I want.” Another person told us, “The staff are well trained, they do their job well.” People and relatives raised concerns about a language barrier between them and some staff. They told us they did not think this impacted on their safety, but they found it frustrating. One person told us, “I don’t think the language barrier is a safety issue but it is so frustrating to keep repeating myself.” Another person was clear that staff made them feel safe but told us, “Staff don’t always listen to what I tell them. I think it’s the language barrier.”

People were supported by staff who were recruited safely. Staff were required to provide satisfactory references and evidence of their right to work in the UK prior to them starting their employment. Where staff had been recruited from overseas, they were required to provide evidence of their English language skills prior to them starting employment to give the provider some assurance they were competent to meet people’s needs. Staffing rotas were implemented in a way that ensured adequate time and sufficient number of carers were allocated to people's calls to meet their needs safely. A clear process was in place to ensure staff remained up to date with their training and competencies.

Staff told us there were sufficient staff to meet people’s needs. Staff told us they felt that enough time was allocated to people’s care calls to meet their needs and they were allocated sufficient travel time. Staff told us they had a 30 minute grace period to attend calls and were not often late. Staff were clear they should contact the office in order for the person to be informed if they found they were going to be late. Staff told us they were provided with sufficient training to meet people’s needs safely. One staff member told us, “[The provider] add more training, we have so much. It was a plus and I applaud Rainbow for that.” Staff told us they were notified prior to their expiry of their training to ensure they kept up to date with any relevant training. Staff told us the registered manager undertook spot checks and competency checks. Staff told us they attended supervisions which helped to identify and address any issues they had or concerns in order to improve care provided to people. Staff told us they had the opportunity to identify goals and aspirations during supervisions to work towards. Competency checks were undertaken as routine every 2 months and as needed if concerns had been raised. Additional spot checks were also carried out if concerns had been identified and the registered manager addressed these concerns in subsequent supervisions. Staff were required to undergo retraining if needed following spot checks. Supervisions were undertaken on a six-monthly basis and appraisals annually. The registered manager acknowledged there had been some occasions where people had not been informed of late calls and this was as staff had not contacted the office to inform them they were late. The registered manager told us they had addressed this with staff.

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.

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