9 March 2017
During a routine inspection
Responsive Care is a domiciliary care agency that provides a range of support to adults living in their own homes. At the time of our inspection the service provided care and support to 22 people.
Responsive Care was re-registered with The Care Quality Commission on 14 August 2015 due to a change of address. This was their first inspection under their new registration.
The registered manager for the service had recently left their post to take up another role within the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had been appointed and at the time of our inspection they had commenced the process of applying for registration with CQC.
People who used the service spoke positively about the care that was provided to them. Staff members also spoke positively about the people who they supported.
We found that people were protected from the risk of abuse. The provider had taken reasonable steps to identify potential areas of concern and prevent abuse from happening. The staff members that we spoke with demonstrated that they understood how to safeguard the people whom they were supporting. Safeguarding training and information had been provided to staff.
The service had developed risk assessments and risk management plans for people. However we found that these did not always include information in relation to conditions such as diabetes and swallowing difficulties. Guidance was not in place to ensure that staff were able to identify and safely manage any potential risks associated with these conditions.
Arrangements were in place to ensure that people’s medicines were administered and recorded. Staff members had received training in safe administration of medicines. We found, however, that details of the medicines that people received were not always recorded within their care documents. There was no medicines risk assessment for a person whose medicines were administered by staff members.
The provider had staff recruitment processes in place to ensure that workers employed by the service were suitable for the duties that they were undertaking. However, we found that the provider had not obtained references for a recently appointed staff member who was supporting people who used the service.
Staffing rotas at the service met the current support needs of people. There was a system for ensuring that care calls were managed and monitored and staff members had time allocated for travelling between care calls.. Staff and people who used the service had access to management support outside of office hours via a telephone on-call service.
Staff members at the service received training that was relevant to the needs of the people they supported. The provider also enabled staff members to achieve a qualification in health and social care. We saw that staff received regular supervision sessions with a manager to ensure that they were supported in their work.
The service was meeting the requirements of the Mental Capacity Act 2005. Capacity assessments were in place for people. People were asked for their consent to any care or support that was provided. However we found that where people were unable to record consent this was not always noted in their care files.
People’s religious and cultural needs and preferences were supported. The people we spoke with told us that staff members respected their wishes and treated them with dignity and respect. However, the care plans that we saw did not always record information about how staff should support people’s needs in relation to communication and dietary requirements. Staff members spoke positively and respectfully about their approaches to care and the people that they provided care to.
People who used the service told us that they knew what to do if they had a concern or complaint. Complaints that had been received by the service had been fully investigated.
People who used the service and staff members spoke positively about its management. A range of processes were in place to monitor the quality of the service, such as audits and spot checks of care practice. Although a number of improvements had been made, there was still work to do in order to meet the regulations of The Health and Social Care Act 2008 (Regulated Activities) 2014.
We found two breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.