Rainbow Care Solutions (Merseyside)

Rainbow Care Solutions (Merseyside) provides care and support to people in their own homes across the St. Helens area. 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. At the time of the inspection there were 32 people were being supported with personal care.

People’s experience of using this service and what we found

Systems were in place to minimise the risk of harm to people. Procedures were available to staff for use in the event of a concern being raised. People told us they felt safe when their care and support was delivered.

People were supported by care staff who had been safely recruited and there were enough staff employed to meet people's needs.

Known risks to people were reviewed, assessed and wherever possible, mitigated. The service worked with other agencies and healthcare professionals to support people with their safety and health.

People told us that staff delivering their care and support were respectful, caring and kind.

People were supported to express their views about the service. The provider was aware of their legal obligations. The service was in the process of introducing a new improved electronic management system. People and their family members had access to their records and care planning information on-line.

Rating at last inspection

The last rating for this service was good (published 16 May 2023).

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Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service is good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Rainbow Care Solutions (Merseyside) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the time of the inspection, the location did not provide care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right support, right care, right culture, as it is registered as a specialist service for this population group.

About the service

Rainbow Care Solutions (Merseyside) provides personal care and support to people in their own homes across the St. Helens area. 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. At the time of the inspection there were 41 people being supported with personal care.

People’s experience of using this service and what we found

Right Support:

People, and those who knew them well, were included in planning their care to ensure it met their needs and took account of their wishes.

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 received the support they needed to take their medicines and to maintain their health. People were supported to manage their own medicines and to maintain their independence.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Staff were committed to providing people with good quality, person-centred care. People received kind and compassionate care because staff understood and responded to their individual needs.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People received care from a small team of staff who they knew.

Right Culture:

Staff placed people’s wishes, needs and rights at the heart of everything they did. People received good quality care and support because staff were trained to meet their needs.

People were asked for their views and their feedback was used to further improve the service.

The registered manager had developed a transparent, open and honest culture. Staff felt confident to question and report poor practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 September 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We identified the service may have improved since the last inspection. We carried out a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rainbow Care Solutions (Merseyside) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and phone calls to engage with people using the service as part of this performance review and assessment.

Rainbow Care Solutions provides care and support to people in their own homes across the St. Helens area. 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. At the time of the inspection there were 14 people were being supported with personal care.

People's experiences of using this service and what we found

We could not be certain that people always received the care and support they needed to remain safe. We found evidence that some staff had falsified call times which meant it was difficult to establish whether they were visiting people at the agreed times and were staying for the amount of time they were meant to. We were given mixed feedback from people and family members around call times with some telling us staff arrived on time and others telling us staff were often late.

The governance systems in place had failed to identify that staff were falsifying call times. These issues were discussed with the registered manager and an action plan was implemented immediately to address the concerns highlighted.

Whilst most people and their family members provided positive feedback about staff and the service they received, the issues around the falsification of records raised questions around the honesty and integrity of some staff working for the service.

On-the-whole, we received positive feedback from people and family members about how safe people felt with the staff who supported them. However, two family members told us their relatives did not always feel safe when staff not familiar with their mobility needs and equipment supported them. This was discussed with the registered manager and action taken to address these concerns. Risks to people had been identified and guidance was in place for staff to follow in order to keep people safe from harm. Staff received training in relation to safeguarding and knew how to identify and respond to allegations or potential incidents of abuse.

Staff had access to up-to-date information and guidance about infection prevention and control; particularly in relation to COVID-19. People told us staff wore the correct PPE when carrying out visits and staff told us they had access to enough supplies of PPE. The registered manager ensured staff accessed regular COVID-19 testing and kept a record of all results received.

Whilst there were enough suitably qualified and skilled staff to cover the hours of support people needed, some records and feedback we received showed that not all calls were completed at the required times and staff did not always stay the agreed amount of time. The registered manager told us a recent COVID-19 outbreak amongst staff had impacted the service and had resulted in people's calls being affected. Safe recruitment processes were in place and relevant checks were completed on new applicants to ensure they were suitable to work for the service. There were enough suitably trained staff to cover people's calls

The registered manager and senior staff carried out regular audits and checks in areas such as call times, medicine administration and staff competency and performance. Where issues were identified, action was taken to address them. Staff spoke positively about the support they received from the registered manager and office. They told us they were given opportunities to share their views or give feedback about the service. Regular surveys and reviews were completed with people and their family members to gather their views about the service they received.

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

Rating at last inspection

The rating at the last inspection was good (report published 20 December 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staff falsifying records in relation to people's call times. A decision was made for us to inspect and examine those concerns.

We have found evidence that the provider needs to make improvements. Please see the “Is the service safe?” and “Is the service well-led?” sections of this report.

The provider took prompt action to address the concerns and the risks associated with staff falsifying people's call times.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rainbow Care Solutions on our website at www.cqc.org.uk.

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.

We have identified breaches in relation safe care and treatment and good governance. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Rainbow Care Solutions uses an electronic care system to record all details regarding the care and support required for people using the service. Paper copies of people’s care plans are kept in their own homes to ensure staff and other relevant people have access to update relevant information including call times, identified risks and individualised care and support needs. This ensures that people receive the right care and support in a safe way. Staff are provided with electronic devices to allow them to log in and out of people’s homes to ensure that visits are completed at the right time.

People told us they felt they received care in a safe way. Individual risks to people and the environment had been identified and assessed and measures put in place to manage them and minimise the risk of avoidable harm occurring. Staff showed a good understanding of their roles and responsibilities for keeping people safe from harm. Medicines were managed safely by trained staff who ensured that people received medicines at the right time.

Sufficient numbers of suitably qualified and skilled staff were deployed to meet people’s individual needs. Staff had received a wide range training and support to enable them to carry out their role safely. People told us they received the right care and support from staff who were well trained and competent at what they did

Staff showed a genuine motivation to deliver care in a person centred way based on people’s preferences and likes. Staff treated people with kindness, compassion and respect and staff ensured that people’s dignity was maintained at all times. People spoke positively about the care and support they received.

People’s needs and choices were assessed and planned for. Care plans identified intended outcomes for people and how they were to be met in a way they preferred. People received support to maintain good nutrition and hydration and their healthcare needs were understood and met.

Records relating to consent for care were not always accurately completed, however people told us they were always offered choice and control over the care they received. We have made a recommendation regarding this.

Care was delivered in a personalised way which was in line with information recorded in people's care plans. People and family members knew how to make a complaint and they were confident about complaining should they need to. They were confident that their complaint would be listened to and acted upon quickly.

The leadership of the service promoted person centred care and a positive culture within the staff team. People, family members and staff all described the registered manager as supportive and approachable. The registered manager and provider showed a continued desire to improve on the service and displayed a good knowledge and understanding around the importance of working closely with other agencies and healthcare professionals where needed. Effective systems were in place to check on the quality and safety of the service and improvements were made when required.

Rating at last inspection: This was newly registered and therefore had not been previously inspected by the Care Quality Commission.

About the service: Rainbow Care Solutions is a small domiciliary care service that provides support and personal care to older people in their own homes. At the time of our inspection the service was supporting 27 people with personal care.

Why we inspected: This was a planned comprehensive inspection for a newly registered service.