Reagle Home Care Services received a Good rating across all five key questions following a focused inspection of Safe and Well-Led domains (with prior ratings carried forward for Effective, Caring and Responsive). The service demonstrated robust safeguarding, medicines management, infection control, staffing practices, and quality assurance systems with strong positive feedback from people and their families.
Strengths
· Robust recruitment processes including DBS checks and professional references, with new care packages only accepted when sufficient staffing capacity exists
· Staff completed safeguarding training and demonstrated awareness of abuse types and appropriate reporting procedures
· Medicines administration training and regular competency checks ensured safe medication support
· Effective infection prevention and control measures including PPE provision and updated COVID-19 action plan
· Accidents and incidents reviewed to identify trends and share learning with staff
Reagle Home Care Services received an overall Good rating across all five key questions at this October 2017 inspection, demonstrating clear improvements since the previous inspection where recruitment and governance concerns were identified. Minor areas for development included formalising emotional health risk assessments and an isolated failure to notify CQC of a safeguarding concern, which had since been rectified.
Concerns (3)
moderateIncident learning: “There had been a recent occasion where a safeguarding concern had been identified...but had not understood the need to notify the commission.”
minorCare planning: “Further written developments were needed in regard to people whose emotional health and subsequent behaviour might require different ways of support.”
minorMissed or late visits: “We saw past staff rotas had not allowed sufficient time for travel between visits. However we saw rotas were now changed to give sufficient time for staff to travel.”
Strengths
· People felt safe and staff were knowledgeable about safeguarding identification and reporting
· Safe and effective recruitment practices with all pre-employment checks completed
· Staff received structured induction, ongoing training including end of life and dementia courses, and regular supervision
· People were treated with dignity and respect and involved in planning and reviewing their care
· Continuity of care improved with named staff and backup arrangements communicated to people
Reagle Home Care Services received an overall rating of Requires Improvement at its first inspection since registering in 2014, with Safe, Responsive, and Well-Led domains all requiring improvement due to inconsistent recruitment checks, inadequate care plan detail, and a breach of Regulation 17 for failing to maintain adequate quality monitoring systems. Effective and Caring were rated Good, reflecting trained and supportive staff who treated people with dignity and respect.
Concerns (9)
criticalGovernance: “There were not adequate systems to monitor and improve the quality of the services provided. This was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) 2014”
criticalSafeguarding: “We saw there was no risk assessment or plan to mitigate any risk in place which is required when a person's DBS had disclosures.”
moderateRecord keeping: “There was no system to maintain an audit trail of all key staff recruitment documents which ensured that people had been recruited robustly and were fit to work in the care sector.”
moderateStaff training: “There was no system to record and monitor staff training which meant some staff training was out of date or had not taken place.”
moderateCare planning: “Care plans did not always give staff clear guidance on how to deliver care or support… where people had some form of dementia there was no information to guide staff”
moderateSupervision / appraisal: “There was no formal supervision in place for live in carers who, although self-employed, were managed by the agency as were the care packages they were employed for.”
moderateStaff competency: “A number of staff had not received the [DBS] clearance until a couple of months after they began working.”
minorPerson-centred care: “Another care plan read that the person was able to prepare and cook their own food which was not the case as food was prepared for them.”
minorCommunication with families: “One relative said they felt they needed to check when there was a change in medicines as care staff did not always hand over information about medicines.”
Strengths
· People told us they felt safe with the care they received and were positive about the management and ethos of the service.
· Staff were caring, kind and respected people's dignity and privacy.
· People's consent was sought prior to care being delivered and staff were clear about obtaining consent.
· Staff received training in safeguarding and were able to explain how to identify and report concerns.
· Regular staff meetings and individual supervision were in place, and staff felt supported by the manager.