Care Assistance, a domiciliary care agency in Rotherham supporting around 100 people, was rated Good overall following a remote inspection in November 2022. Only Safe and Well-led were assessed; both were rated Good, with Well-led improving from Requires improvement at the previous inspection.
Strengths
· People and relatives spoke highly of staff and the manager, highlighting warmth, humour, and responsiveness to changing needs.
· Medicines were managed safely with regular audits in place.
· Staff had received safeguarding training and knew how to report concerns; required notifications were made to CQC and local authority.
· Safe recruitment practices including DBS checks and references prior to employment.
· Manager had good oversight of incidents and made service changes when required.
Care Assistance improved to Good overall, with notable progress in medicines management since the previous inspection, though Well-led remained Requires Improvement due to staff reports of disorganisation, poorly planned rotas without travel time, and a small number of unreported notifiable incidents. Relatives praised the highly visible registered person, but management oversight and consistency need strengthening.
Concerns (6)
moderateGovernance: “Some staff said they found the service to be disorganised; they told us of examples of not receiving their rota until the night before work, or concerns not being addressed.”
moderateStaffing levels: “Some staff told us they did not feel they had time to complete their calls as the rotas were not organised well, for example care calls had been scheduled without travel time in between.”
moderateLeadership: “the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.”
moderateIncident learning: “We identified a small number of further incidents that should have been notified to us, and provided the registered person with a reminder of notifiable incidents following the inspection.”
minorInfection control: “we noted only a small number of staff, according to the provider's own records, had undertaken training in infection control.”
minorMissed or late visits: “Some people told us care calls were not always at the agreed times, although predominantly they said this was when the care staff had been delayed due to the needs of other people.”
Strengths
· Considerable improvements made in medicines management since last inspection
· Staff safely recruited with references, identity and DBS checks
· Registered person described as highly visible and accessible; relatives praised service as 'a Godsend' and 'above and beyond'
· Good systems for obtaining consent in line with the Mental Capacity Act 2005
· Care plans and risk assessments in place with people and relatives involved in agreeing and reviewing
Quality-Statement breakdown (21)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Meeting people's communication needsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersNot rated