Royalcare- Thanet

Updated 25 May 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 13 April 2022 and ended on 22 April 2022. We visited the location’s office/service on 13 April 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the Well-Led section of the full inspection report for further details. We used all this information to plan our inspection.

During the inspection

We spoke with one person and two relatives about their experience of the care provided. We spoke with two staff, the branch manager, registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We looked at training data, quality assurance records and meeting minutes.

Updated 25 May 2022

About the service

Royalcare Thanet is a domiciliary care agency which provides care and support to people living in their own homes. At the time of our inspection there were 16 older people using the service. Not everyone who used the service received personal care. The Care Quality Commission (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 were not supported by staff who had been consistently safely recruited. The provider could not be assured they had obtained full employment histories. References, when new staff had previously worked in social care had not always been obtained to ensure they were of good character.

COVID-19 risk assessments for people and staff were not robust. The registered manager took immediate action to address this during the inspection.

Checks and audits were not consistently robust. When the previous registered manager had left the service, there was no system in place to review their emails to ensure there was no outstanding work to be followed up.

People told us they were supported by regular staff, who arrived on time and stayed the right amount of time.

People told us they felt safe with staff from Royalcare Thanet supporting them. They knew how to contact office staff if they had any concerns. Staff understood how to keep people safe and knew they could report concerns to the registered manager. They felt the right action would be taken.

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.

People’s physical, mental health, social and emotional needs were assessed and regularly reviewed. People and their relatives were involved in their care and support. Care plans provided staff with detailed information about how people preferred to be supported and contained information about their life history, family and any goals they wanted to achieve.

People and their relatives said staff were patient, caring and kind. They knew how to complain and had no complaints about the service they received. They felt the service was well-managed and told us the communication was good.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. At the time of the inspection the service was not supporting anyone with a learning disability.

Right support: Model of care and setting maximises people’s choice, control and Independence

People were supported to be as independent as possible and make their own decisions. People were able to discuss their personal goals and talk to staff about how these could be achieved. People’s communication needs were assessed and there were processes in place to provide information in a way people could understand. For example, using picture cards or larger print.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights

People received care and support, planned with them and their relatives, which concentrated on their individual needs and preferences. A holistic approach was used to consider people’s physical, emotional, psychological and social care needs. Privacy and dignity were respected, and people’s human rights were protected.

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The provider’s values of ‘Care, Attentiveness, Respect and dignity and Empowerment’ were shared by the staff team. People and their relatives spoke positively about the leadership.

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 December 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on our inspection programme.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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 will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to recruitment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.