JRH Support - Head Office

Updated 22 November 2019

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 team consisted of one inspector and an 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in [their own houses and flats] [and] [specialist housing]. They also provided care and support to people living in their own homes at a number of 'supported living' settings, so they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

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

This inspection was announced.

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.

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. We contacted Healthwatch, which is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 of this information to plan our inspection.

During the inspection

We spoke with six people, six relatives, three members of the care staff, a care coordinator, two service managers, the general manager and the registered manager. We also spoke with external social care professionals for their feedback about the service.

We looked at all or parts of the care records and other relevant records of three people, as well as a range of records relating to the running of the service. We also reviewed staff records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data quality assurance records, complaints and risk management for people who were responsible for their own medicines.

Updated 22 November 2019

JRH Support – Head Office is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community, including older people and people living with dementia, learning disabilities, autism and other complex needs. At the time of the inspection 43 people received a regulated activity of personal care and nine people were living in supported living accommodation.

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

Systems were in place to protect people from harm and keep them safe. The service employed a safeguarding lead responsible for completing safeguarding investigations. Risks were assessed to manage known risks for people. Risk assessments were reviewed and updated on a regular basis. There were sufficient staff to support people. Rotas were planned in advance and robust recruitment was followed in line with the providers policy and procedures.

People were supported with their medicines in the way they wanted. Staff who administered medicines were monitored and competency tested to ensure they administered in a safe way.

Staff followed appropriate protocols for infection control. Lessons learnt were recorded for reflective learning to ensure action was taken to reduce risk and keep people safe.

People’s needs had been assessed to ensure they had their choices and preferences met. Staff received relevant training to ensure they supported people effectively. People were supported with their dietary needs in line with their support plan. People were supported to attend healthcare appointments and received relevant support to maintain their health and wellbeing. People were responsible for maintaining their own environment to ensure they had relevant support equipment and a hazard free home. 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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People confirmed the staff were kind, caring and compassionate. Staff cared for people in a person-centred way. The service supported people to share their views and arranged advocacy services when needed. People were treated respectfully and supported to lead independent lives.

People were encouraged to make choices for themselves. Each person had their communication needs met. People participated in hobbies and interests of their choice, which helped avoid isolation. Systems and processes were in place to monitor, analyse and manage complaints. People’s end of life wishes were considered.

People were supported on their journey of life by staff who were hands on, approachable and empowered to suggest change. The provider understood their legal responsibilities and completed comprehensive quality audits that helped to improve care and support for people. Relationships were built up with healthcare professionals to ensure people receive the service they require to manage their condition.

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

Rating at last inspection: Good (report published 27 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.