Background to this inspection
Updated
21 May 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
This inspection was carried out by three inspectors including a pharmacy inspector.
Notice of inspection
We announced the inspection visit 24 hours before it took place. This was because we needed to give the manager time to prepare in advance of our visit due to the COVID-19 pandemic.
Inspection activity started on 12 March 2021 and ended on 9 April 2021. We visited the service on 12 March 2021.
What we did before the inspection
We reviewed the information we received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with five people who used the service and the representatives of a further six people who used the service about their experiences of the care provided. We also spoke with the manager, and eight members of staff including a team leader, a care coordinator, five care staff and the locality trainer. We looked at the recruitment files for two staff employed since the last inspection. A variety of records relating to the management of the service were also reviewed.
Due to the impact of the COVID-19 pandemic we limited the time we spent on site. Therefore, we requested records and documentation to be sent to us and reviewed these off site and continued dialogue with the manager by telephone.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
21 May 2021
React Homecare Ltd is a domiciliary care service providing personal care to 94 people at the time of the inspection. 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.
People’s experience of using this service and what we found
Medicines records and governance arrangements did not assure that medicines were managed safely. We have made a recommendation regarding medicines management.
Whilst the provider had safeguarding procedures in place safeguarding records were not always accurate or up to date to ensure oversite and governance.
The provider's quality systems were not sufficiently robust to identify the concerns we highlighted with medicines and safeguarding records. The provider was very responsive in taking actions to address the issues we found on inspection however we could not fully assess the impact of these actions until they were fully embedded.
People told us that they felt safe whilst receiving care and were complimentary about the standard of care and services they had received.
Risks to people’s health and well-being were clearly identified and care plans set out what support the person needed in the way they wanted their care to be provided.
People received consistent care from staff who knew them well and they were familiar with. One person told us, “Works like clockwork” and another said “I get used to the (staff) and when they come I don’t have to tell them what to do”.
Staff rotas were developed using an electronic call monitoring system. This ensured people received care as and when they needed it and reduced the risk of ‘missed calls’ occurring.
The providers policies and procedures had been revised in the light of the Covid-19 pandemic and staff had received relevant training, and had access to appropriate personal protective equipment (PPE) in accordance with government guidelines.
People who used the service, their relatives, friends and staff were unanimous in their praise for the registered manager. They told us that she was approachable, supportive and always responded effectively to solve problems and improve the service.
Rating at last inspection. The last rating for this service was good (published 13 April 2019).
Why we inspected
We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of Safe and Well led only.
We reviewed the information we held about the service. No areas of concern were identified in other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified a breach of regulations in relation to governance and record keeping at this inspection. Please see the action we have told the provider to take at the end of this report.
Prompt action was taken by the registered manager after the inspection to mitigate risk and improve the quality of care in response to the concerns we found during our inspection.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.