River Stone (UK) Limited, a small domiciliary care agency supporting 3 people, was rated Good overall at its first inspection, with safe, effective, caring and responsive domains all rated Good. The single area of Requires Improvement in well-led related to the absence of a formal auditing system prior to inspection, including unrecorded quality checks and failure to document staff medicines competency assessments, both of which were addressed immediately after inspection.
Concerns (5)
moderateGovernance: “Prior to the inspection there was no effective auditing system in place to support the provider with effective governance.”
moderateMedication management: “prior to the inspection the provider had not recorded they had undertaken staff medicine competency checks to ensure staff were administering medicines correctly.”
moderateRecord keeping: “The provider told us about checks they made to assess the quality of the service, however, these were not recorded and had not aligned with some areas of best practice.”
minorCare planning: “one person was supported with an inhaler. There was a lack of information as to why the person used this medicine.”
minorInfection control: “At the time of the inspection the provider had not undertaken an audit of infection control. However, this was addressed at the time of the inspection.”
Strengths
· People were supported by consistent, small staff teams who knew people well, with no missed calls reported.
· Staff had the skills and knowledge needed, including specialist training for diabetes awareness, learning disability and autism.
· People received kind, compassionate, person-centred care with privacy and dignity respected.
· People and relatives were regularly involved in care reviews and planning.
· Staff worked effectively in partnership with a wide range of health and social care professionals.
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood