Rings Homecare Greater Manchester Also known as RHS GREATER MANCHESTER

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The service was well-led. The registered manager worked closely with the local authority quality assurance and improvement team and the assigned contract and quality monitoring officer for the service. People and their relatives were involved in care planning, reviewing care, and telephone monitoring. The provider had an up to date Statement of Purpose (SoP), which clearly explained the organisations' aims and values; each person using the service was provided with a copy of this within their home file. Staff spoke positively about the service and how it was managed, and all staff felt supported and able to raise any concerns. People and relatives were complimentary about the registered manager and their impact on the service, since starting in post. People and relatives spoke positively about the service and the care and support provided; they felt involved in the service. Staff told us the provider had a whistleblowing and freedom to speak up policy, which they had access to and knew how to report any concerns. No staff we spoke with had needed to raise any concerns. The provider had up to date policies and procedures in place relating to equality and diversity, staff support and well-being. The provider and registered manager completed a number of audits and monitoring processes, to assess the safety and effectiveness of the care and support provided. The provider employed a quality assurance and compliance officer, who completed and oversaw the internal audit process and any monitoring completed. The registered manager also completed weekly and monthly key performance data, which was reviewed by the provider and actions generated as required. People and relatives felt listened to and were able to raise concerns if they needed to. The staff team had the skills, knowledge and experience to perform their roles, and understood their roles and responsibilities. Governance processes were effective. There was a strong sense of trust between leadership and staff.

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.

The registered manager told us how they involved people, relatives and staff in deciding the service’s visions, values & strategy. They said, “All of the people we support, and their next of kin where appropriate, are involved from the beginning, involved in care planning, involved in reviews and telephone monitoring. We provide them with a copy of the statement of purpose, so people know about us as a service.” The registered manager told us they had consulted with staff regarding the contents of people's care review forms and as a result were amending the review forms to include their suggestions. Staff told us the statement of purpose had been shared with them. A statement of purpose is a legally required document that includes a standard set of information about a provider’s service.

The provider and registered manager worked closely with the local authority, and specifically the quality assurance team and the assigned officer for the service. The provider had an up to date Statement of Purpose which clearly explained the organisations aims and values. Each person using the service was provided with a copy of this within their home file. A satisfaction survey was completed with people face-to-face and therefore was not confidential, and the registered manager told us they were looking at ways of gathering this information anonymously. A weekly office staff meeting, and regular team meetings provided staff with an opportunity to contribute ideas and feedback on what was working well and not working well. The registered manager told us they were looking to set up more localised staff 'patch' meetings and exploring other ways for staff to get more involved. People and relatives told us staff were very responsive and helpful when they raised any issues, and were quick to respond. People and relatives were confident any concerns would be listened to and acted on.

Staff spoke positively about the service and how it was managed; they all felt supported and able to raise any concerns. Comments included, “Yes, it is well-run. We get lots of support. The registered manager is approachable and listens to us,” and, “[Registered Manager] is brilliant, a very intelligent lady. If we need anything we just need to ask. She is very responsive to requests for help.” We asked the registered manager how they ensured they were a visible leader. They told us, “I am out and about a lot visiting people, linking in with people & carers. Where necessary I provide care to people, when I can chat with people, as I tend to get more out of them when talking and providing care. I go out to complete care reviews with people and supervisions with staff. We have an open door policy, as I am often out and about, staff ring up, book an appointment and come and see me.” People and relatives were complimentary about the registered manager and their impact on the service, since commencing post. One relative told us, “[Registered manager name] is the new manager and the service has improved no end; she is accessible, approachable and very helpful and I genuinely cannot fault the service during the last year.”

The registered manager had many years’ experience within registered homecare services and was in the process of completing a Level 5 Diploma in Leadership and Management. The care coordinator was also completing the same qualification. The registered manager reported directly to the providers' business development, safeguarding and compliance officer, who was employed by the provider following the previous CQC inspection to ensure the service was safe and to help drive improvements; one of the first changes they made was to appoint a new registered manager with experience of managing domiciliary care services. The registered manager also worked alongside social workers and direct payment brokers.

There was an open, honest and transparent culture within the service; leaders actively promoted staff empowerment to drive improvements and encouraged staff to raise concerns. Staff told us the provider had a whistleblowing and freedom to speak up policy, which they had access to and knew how to report any concerns; no staff we spoke with had needed to report any concerns but were confident they would be listened to if they did. The registered manager told us, “The whistleblowing policy is encouraged during induction and during individual meetings with staff.”

There were mechanisms in place for staff to speak up. Good communication was in place through the on-call system, team meetings and formal individual meetings to ensure staff had regular opportunities to engage with managers. This was supported by policies and information which enabled staff to raise concerns externally if required. Information regarding whistleblowing and the freedom to speak up was contained within the staff handbook, which each staff member was given at the start of their employment. Staff also had access to policy & procedure documents, which were provided by an external company, who ensured these were up to date with the latest information, and in line with regulatory requirements, including the whistleblowing and freedom to speak up policy. People and relatives consistently told us the service was well led under the new manager. One relative said, "The management are so very helpful, and they all do everything they can to support [person]. They [staff] ask us for feedback every 6 months to make sure we are happy with everything."

Staff told us their wellbeing was supported, although this was through the kindness of management rather than any specific initiatives. One staff member told us, “Yes, my wellbeing is supported; there is nothing specific in terms of initiatives, they [the provider] are just nice people and good to work for.” Staff confirmed the provider considered flexible working. One staff member told us, “We have an availability form. They [managers] take on board our views on this.” Another staff member told us they hadn't needed to request flexible working, but were confident if they did, they would be supported. The registered manager confirmed they were happy for staff to work flexibly, although they were also mindful of people’s care and support needs. The registered manager said, “There are quite a lot of examples of flexible working. For example, we work around child care needs, with some staff only working in the morning, others the afternoon or evening. However, I have said to the staff whoever does the morning call, also needs to do the lunch call and whoever does the tea call also does the evening call. This is important for continuity of care, we can’t have 3 or 4 different carers going into a person’s home each day.” The registered manager also explained how staff wellbeing was supported. They told us, “When one of the service users, who had a large care package, passed away, bereavement support was made available for the carers, as they had formed strong bonds with this person and were very upset at their passing."

Up to date policies and procedures were in place relating to equality and diversity, staff support and well-being. Separate meetings were held with overseas workers, to ensure their needs were being met, and so any issues specific to them and their working conditions could be discussed. Although there was no formal staff survey in place, part of the staff 'spot check' covered if they were happy providing the care and if they knew who to speak to if they had any concerns. Staff could email the registered manager directly to raise any issues in confidence. The provider followed equal opportunities processes when recruiting new staff and staffs' equality and diversity was recognised and celebrated.

The registered manager understood regulatory requirements; relevant statutory notifications had been submitted to CQC as required. Work had been completed with care staff around effective record keeping, what the expectations of staff were, and a focus on using the correct language and spelling. Records we viewed during the on-site assessment were of a good standard. The registered manager told us, “Daily notes are constantly checked. Four senior staff do the service user reviews, staff competency checks and also check records for their list of care staff and service users and any issues reported to me. Work has been done with staff around note taking and the importance of info being accurate.” People and relative’s views were regularly sought via care plan reviews, telephone monitoring calls and surveys. We looked at 4 people’s care records which contained this information and found all of these had provided positive feedback about the service and the support they received. A relative told us, "If this conversation had occurred 18 months ago, the feedback would not have been good. Under the new manager the service has improved no end, she is accessible, approachable and very helpful and I genuinely cannot fault the service during the last year. It seems that the staff are much better supported and there is a high standard of care all round."

There were clear and effective governance, management and accountability arrangements in place. The provider and registered manager completed a number of audits and monitoring processes, to assess the safety and effectiveness of the care and support provided. The provider employed a quality assurance and compliance officer, who completed and oversaw the internal audit process and any monitoring completed. Alongside this, the registered manager completed weekly and monthly key performance data, which was reviewed by the provider and actions generated as required. The provider did not use an overarching action and improvement plan, and instead each audit contained individual action plans. From speaking with people, staff and the registered manager, it was clear a number of changes and improvements had been implemented in the previous 6 months; however, these were not documented consistently. We discussed this with the registered manager, who agreed to introduce log for capturing key actions and improvements, so they could better evidence the positive work being done. We asked staff about record keeping and how this was done. One staff member said, “We have an app on our phones, and we record everything on there. The information comes through to the office, so they can monitor this.”

People and relatives spoke positively about the service and the care and support provided; they felt involved in the service and were kept updated with any changes or issues. A relative told us, "I can't see any improvements that need to be made and I would happily recommend the service. The management and staff have all worked really hard for improvement and we are very happy with the service." A second relative also told us how their requests were listened to and acted upon. People and relatives were involved in discussions about the care being provided. A person told us, "All the staff in the office and [registered manager name] are really helpful. I have never had to complain but when I do call they [staff] will always listen and act on what I've said." Another relative commented on how they felt the staff were all clearly very passionate and genuinely cared about their work, which was very evident.

The registered manager told us they worked in partnership with a girls school and a number of professionals who provided support to the service. Staff linked in with direct payment teams so they knew what support they could offer to people. A partnerships file was in place, containing a list of useful numbers, such as social workers, the mental health service, equipment (stores), district nurses and local authority safeguarding. The registered manager told us any learning and improvement which was identified by the local authority was cascaded down to all team members, so all staff were aware.

We received positive feedback from the local authority about the registered manager. The local authority quality monitoring officer told us, “We have a good working relationship, and [registered manager name] is very open and transparent. I recently carried out a quality monitoring exercise in February 2024 which came out as good."

The service worked closely and in partnership with a number of other organisations. These included a local hospital, whose physiotherapy department provided bespoke training as and when needed; a local healthcare provider supplied training and support to people with feeding tubes, and those who support them. The registered manager also worked with the quality monitoring officer from the local authority to identify, make and sustain any required improvements.

We asked the registered manager whether any innovative practices have been implemented within the last 12 months or were planned to be introduced. They told us, “There are lots in the pipeline. We have the supported living service and are looking at using this to support the pathway for some people from homecare through to greater independence. A new app / system is being developed by the provider, which will take over responsibility for care planning.” The registered manager also told us about a new food bank project which had been set up. To access food banks within Bolton, people have to go through a referral process, either via their GP or social worker. As a result, the provider decided to create their own foodbank, which could be accessed by staff and people using the service. The registered manager told us how learning, actions and outcomes from any investigations into incidents, accidents or complaints were shared with wider staff team. They stated, "We will sit down with carers and go through any issues. The office staff team have a meeting every Monday and information would be shared at this meeting. If needed, we would put an action plan in place at this meeting. The private chat group we have set up is used for communicating information to staff.”

Information about actions, improvements and any lessons learned was recorded on each audit document completed, as well as accident, incident and safeguarding records. The provider sought the views of people using the service to help drive improvements via a questionnaire. The questionnaire contained 20 questions which covered if people were happy with their care, if needs were being met, timeliness of care staff, if they were treated with dignity & respect and if they felt involved in their care. The form also contained a section for recoding any issues identified along with agreed actions. During the process, staff discussed whether any of the person’s needs had changed and if updates were needed to their care plan or any risk assessments. Relatives were positive about how the quality of care provided to people had improved; a relative told us, "The office staff are brilliant, and they always answer the phone. Any issues are responded to very quickly and though I've not needed to complain, I know that they would listen and respond appropriately, I would definitely recommend them as a service."