Ruby Grange Homecare Limited

Updated 12 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 November 2017 and was announced. We gave the provider 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Before the inspection, we reviewed information we held about the service. This included notifications we had received. A notification is information about important events that the provider is required to send us by law.

One inspector carried out the inspection. During our inspection, we looked at three people’s care records. This included their care plans, risk assessments, medicines records, and daily notes. We reviewed three staff personnel files. This included their recruitment, training, and supervision records. We spoke with three support staff, the registered manager, and two directors who were involved in the day to day management of the service.

Following the inspection, we spoke with two people who used the service and three people’s relatives.

Updated 12 January 2018

This inspection took place on the 14 November 2017 and was announced. We told the provider two working days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and staff might be out visiting people.

The service is a domiciliary care agency and is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom could be living with dementia and younger disabled adults.

At the time of our inspection, the provider was offering a service to 14 people.

This was the service’s first inspection following their registration with the Care Quality Commission on the 5 December 2016. There was a registered manager in post. 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.

Staff and the management team were described as very caring and kind. Staff demonstrated an empathetic approach to working with people and supported people’s emotional wellbeing. People were supported to access appropriate health care and staff recorded what people ate and drank to monitor their nutrition and hydration. Staff demonstrated they understood they should report any concerns about people’s health to the management team so they could take appropriate action.

The registered manager assessed the staffing requirements within the service to ensure they had enough staff before accepting new referrals. The management team supported people with their care when there were staff absences to ensure a consistent service.

The provider followed safe recruitment processes to ensure staff were suitable to work in a caring capacity. Staff were given a thorough induction and training to equip them to undertake their work.

The management team had undertaken risk assessments to identify the risks associated with the delivery of care in a person’s home, but sometimes these lacked a person centred approach and did not state the level of risk to the person. However, care plans were thorough and contained good guidance for staff to mitigate risk. We brought this to the registered manager’s attention and they addressed this following the inspection.

Staff were not administering medicines at the time of our inspection however staff had received training and had clear guidance about who administered medicines and the type of support people needed with their medicines.

The management team understood their responsibility under the Mental Capacity Act 2005 and ensured people’s rights were being upheld. Staff demonstrated they asked people’s consent before proving care and support.

People had person centred plans that gave guidance to staff about how they wanted their care delivered. Care plans were signed by people to show they agreed with the content and these were updated and reviewed on a regular basis to capture changing circumstances.

People and relatives said they knew how to complain and they found that their concerns were addressed in a timely manner by the registered manager.

The management team shared the company’s vision and ethos with the staff in their induction and training. They acted as role models to show how they wanted care to be delivered.

The management team had a good oversight of the way the service was provided because they had quality assurance systems including audits and checks to ensure the quality of the care provided.

The management team had joined a national organisation and were accessing training to ensure they kept abreast of good practice.