Right at Home Enfield

Updated 7 August 2021

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and one 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 supported this inspection by carrying out telephone calls to people's relatives following the on-site visit.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 14 April 2021 and ended on 17 May 2021. We visited the office location on 23 April 2021. Following the on-site inspection, we completed the inspection via phone and e-mail. On 14 April 2021, we gathered feedback via telephone from people and relatives.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and nominated individual, who is also the managing director of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at four staff files including recruitment, supervision, appraisal and induction records. We also looked at completed quality assurance sport checks.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We were sent further information to support the inspection. We spoke with three people that used the service and 11 relatives. We looked at six people’s care plans, risk assessments and other information used to plan and provide care for people. We also looked at numerous quality assurance documents, policies and procedures, six people’s medicines records, staff training records and other documentation related to the running of the service.

Updated 7 August 2021

About the service

Right at Home Enfield is a domiciliary care agency providing personal care to people living in their own homes. The service supported older adults, many of who were living with dementia. At the time of the inspection, the service was supporting 17 people.

Not everyone who used the service received 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.

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

People benefited from an outstanding service that met their needs, understood people as individuals and held values that placed people at the heart of their care. People and relatives overwhelmingly told us of their satisfaction with the care and support they received. They felt staff were responsive to their needs and enabled them to live their lives in a way that promoted their independence and enjoyment of life. People and relatives consistently praised the caring nature of staff.

Staff were committed to providing a wide range of tailored activities to people in their own homes and in the community. The service recognised COVID-19 meant people may experience increased isolation and loneliness. Staff went above and beyond to help people prevent this, ensuring special events were celebrated, encouraging and supporting people to take part in activities they had previously enjoyed and enabling people to access the local community. The service regularly reviewed people’s care and support needs.

The service was committed to improving the lives of people living with dementia. There were several initiatives to stimulate and involve people including the use of virtual technology which helped people reminisce and open up. The management of the service was actively involved in the local community to raise awareness of dementia.

There was a focus on proactively engaging people in planning their own care. The service understood that each person they worked with was an individual with different wants and needs and person-centred care was evident throughout the inspection.

There was exceptional management oversight of the service. The management team were extremely involved in all aspects of the service and knew every person and their relatives well. People and relatives told us they felt comfortable and happy talking to the managers at any time. Staff were valued and praised by the service including regular awards for staff that had gone above and beyond. There were champions for dementia care and medicines care who ensured best practice and shared this with the wider team. There was a low turnover of staff which reflected the outstanding support and training they received to carry out their role. This also meant people had the same care staff and were able to build rapport with the staff visiting them.

Relevant checks had been completed to make sure new staff were safe to work with vulnerable adults. People received their medicines safely and on time. People were positive about the support staff gave them to take their medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 May 2019 and this was the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.