Archived: Rapid Improvement Care Agency

At our previous inspection in October 2014 we found that people's views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care. We found that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. We found that people were cared for by staff who were not being supported to deliver care and treatment safely and to an appropriate standard. We also found that the provider had an effective quality assurance system but had not used it. The provider had also not implemented an effective system to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Is the service safe?

People told us they felt safe with the service they received. They told us they were treated with respect and dignity by the care workers

Recruitment practice was safe. The registered manager ensured that care workers were appropriately qualified to meet the care needs of people who used the services. This helped to ensure that people's needs were met.

Care workers had received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Is the service effective?

People who used the services health and care needs had been assessed and there was evidence they had been able to express their views and preferences. People knew they had a care plan and they told us they had been involved in their care and support planning. We inspected people's care files and found they included essential information about the person, needs and risk assessment information and care plans.

Is the service caring?

People who use the services were supported by staff in a polite and respectful way. All of the people we talked with said their care workers treated them well and respected their privacy.

People who use the services told us they had discussed their care plans with the office and that they were able to discuss relevant issues and make decisions about what they wanted to do. People's comments on their experience with this agency reflected a caring service in the care and support they received.

Is the service responsive?

People told us that their care workers would sometimes do additional tasks for them if there was time available. Care plans had been reviewed regularly and people told us that they felt well supported.

Is the service well-led?

At this inspection we found that this agency had good quality policy and procedures that had been implemented and more regular checks carried out to assess and monitor the quality of services provided.

The views of people who used the services had been asked and the information had been analysed. As all the feedback was positive no further action was required.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service caring?

Five of the ten relatives of people we spoke with told us that the care workers did not carry out all the tasks required of them. One person told us that their care worker stayed for less than half the time allocated to them. They said 'the staff are here for 20 minutes and then they go. If the time lost (5 hours) was added up over the week they could give me so much more help'. Another person said, 'The care worker is always late and then my relative is not ready for the day ahead'. A third person told us, 'They seem to find it difficult to carry out what is needed for my relative. The consistency of care is poor, they are ok with simple tasks but my relative has complex needs so it's just as well I'm here to keep a check on things'. Two people told us that the care provided by Rapid Improvement was good. Their care workers were not the same people as those allocated to the other four people who we spoke with. This indicated that the quality of care lacked some consistency.

When we asked ten relatives of people if the care provided was the same as was in their care plan, six people were unaware that they had a care plan and therefore did not understand that there were care and treatment choices available to them. The same six people told us that they had not been consulted about the care provided for their relatives and they told us that they understood this was because the care provided by Rapid Care was paid for by social services.

Was the service responsive?

People told us that their care workers would sometimes do additional tasks for them if there was time available. Care plans had not been reviewed regularly and some people told us that they did not feel well supported.

Was the service safe?

Relatives of people who use the services told us they were treated with respect and dignity by the care workers. People told us they felt safe with the service they received.

Recruitment practice was safe. The registered manager ensured that care workers were appropriately qualified to meet the care needs of people who used the services. This helped to ensure that people's needs were met.

Was the service effective?

People who used the services health and care needs had been assessed but there was no evidence they had been able to express their views and preferences. Some of the people we spoke with did not know they had a care plan and so could not have been involved in their care and support planning. We inspected five people's care files. They included essential information about the person, some needs and risk assessment information and brief care plans.

Care workers had not received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Is the service well-led?

At this inspection we found that this agency had policy and procedures in place. However we found that they had been poorly implemented and the regular checks to assess and monitor the quality of services provided had not been carried out.

The views of people who used the services, their representatives and care workers had been asked for their views in the agency's feedback questionnaires. However this information had not been analysed and no action had been taken in response to what had been said so that it could be used to improve the quality of the service where required.

People we spoke with told us they were most happy when they had the same carer looking after their needs. Some people told us they had not been happy with their initial carers and had spoken to the office about this, one person told us 'we were unhappy with our first carer, but we spoke to the manager. They were really supportive and changed our carer, we have no complaints now'.

People told us they had been involved in their initial assessments of care and felt their ongoing care and support had been explained to them and met their individual needs.

We spoke to the provider / registered manager and three care workers. We found there were effective recruitment procedures in place for new staff and existing staff told us they felt properly supported to provide care to people using the services.

We saw there were effective systems in place to monitor the quality of care provided to people who use the service.

However, although people said they were satisfied with the care they or their loved ones received from the agency; we found peoples care may not always be delivered to an appropriate standard because staff had not been suitably trained in some key areas of their role and did not have sufficient opportunities to review their practice. We also found the provider had not developed enough effective systems to regularly assess and monitor the quality of service that people received.