About the service: Edith Healthcare Ringwood is a domiciliary care agency that provides personal care and nursing care to people in their own homes. At the time of the inspection, they had been operating for just over a year and 15 people were using the service. The registered manager was the only registered nurse currently employed by the service and was supported by six care staff. People’s experience of using this service: The registered manager had not ensured that all of the required checks had taken place before staff were employed.
The systems in place had not been fully effective in assessing, monitoring and improving the quality and safety of the service.
Whilst there was a culture of openness and transparency within the service, there was no robust system in place to record safety concerns, incidents or near misses such as falls or medicines errors.
Best practice frameworks for the safe management of medicines needed to be further embedded.
Some aspects of the premises were not entirely suitable for the purpose for which they were being used. We have asked the registered manager to undertake a robust risk assessment and continue to review this to assure themselves that they are meeting their obligations under Health and Safety at Work Legislation.
People were supported to have maximum choice and control of their lives and staff supported them in their best interests; the policies and systems in the service supported this practice.
There were sufficient numbers of care workers available to meet people’s needs and the service they received was reliable with good continuity of care.
Systems and processes were in place to safeguard people from the risk of abuse.
Good practice guidance was followed to ensure infection prevention and control processes were
implemented.
People felt their needs were met effectively and everyone was happy to recommend the service to others.
Staff felt well supported and received an induction and regular training opportunities to keep their knowledge up to date.
People’s nutritional needs were met.
Staff liased with other health care professionals to help ensure people received timely and effective healthcare.
People were supported by staff who were kind and caring. People received regular and consistent care workers which meant they were able to develop meaningful relationships with them.
Staff displayed a genuine desire to enhance people's wellbeing and spoke of the importance of making a difference to people’s lives and helping them to remain in their own homes.
People had a choice about all aspects of their care including the preferred time of their care calls and the level of support they required. Relatives praised the way in which staff worked in partnership with them to meet people’s needs.
Staff helped and encouraged people to stay independent. Each person was treated with respect and the support they received helped to maintain their dignity.
All of the staff we spoke with were knowledgeable about people's individual needs and were able to talk at length about people’s preferences and preferred routines. This helped to ensure that people received care that was personalised and responsive to their individual needs.
The care being provided was having a positive impact on people and there were examples of staff going above and beyond to support people.
People and their relatives had been asked to share their views about the quality of care they received. They were confident that any concerns or complaints would be listened to and acted upon.
Feedback about end of life care was positive. End of life care planning was an area which could be further developed to ensure these provided a fully person centred record of people’s known wishes and preferences.
The registered manager and staff worked well together to ensure the effective day to day running of the service.
It was a central part of the registered manager’s vision for the service that it retained a strong emphasis on person centred care and this was a strength of the service.
People, relatives and staff were positive about the leadership of the service and told us the registered manager was approachable and supportive.
The registered manager supported the development and learning of staff which meant people received effective support from staff.
The registered manager continued to practise as a registered nurse and undertook periodic shifts in clinical settings to continue to practice their skills, knowledge and experience as a registered nurse. However, we have made a recommendation that they ensure they have access to ongoing and regular clinical or professional supervision and that a suitable programme of mentorship is in place and documented.
Why we inspected: The inspection was a scheduled inspection based upon our methodology for newly registered services.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see what action we have taken at the end of this report.
Follow up: Going forward we will continue to monitor this service and plan to reinspect in line with our re-inspection schedule for those services rated ‘Requires Improvement’.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk