RBK Solution Ltd is a domiciliary care agency providing personal care to people living in their own homes. The Care Quality Commission (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. At the time of our inspection two people were receiving care at home from the provider. We conducted our on-site assessment of this service on 9 October 2024 and off-site assessment activity continued until 22 October 2024. The registered manager and staff understood their responsibilities to protect people from abuse and avoidable harm. The provider had an up-to-date safeguarding policy and staff received safeguarding training. People were supported with risk assessments, and care plans provided staff with guidance on delivering care. Support was provided in a safe and person-centred way. People’s needs were assessed, and they were supported to have regular reviews of their care and support. Staff supported people’s access to healthcare professionals and services. Support was provided in line with people’s preferences and their consent was obtained before care was provided. The service had a registered manager in post . People, relatives and staff felt supported by the registered manager and comfortable sharing their views. The provider worked collaboratively with health and social care professionals and other organisations to meet people’s needs.
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First inspection of this small domiciliary care agency identified three regulatory breaches relating to risk assessment (Reg 12), staff training and supervision (Reg 18), and governance oversight (Reg 17). Despite these failings, people and relatives reported caring, reliable, person-centred support from a consistent group of dedicated staff.
Concerns (7)
criticalCare planning: “most did not include enough sufficiently detailed risk management plans. Risks associated with people's home environment, moving and handling, skin integrity and nutrition had not been properly assessed.”
criticalStaff training: “some staff had not completed training in dementia awareness, safeguarding adults, moving and handling, mental capacity and deprivation of liberty safeguards, food hygiene, infection prevention and control, end of life care and equality and diversity.”
criticalSupervision / appraisal: “Staff had not attended any formal individual or group supervision meetings with the registered manager or their fellow co-workers, had their overall work performance formally appraised in the past 12 months”
criticalGovernance: “The provider had governance and monitoring systems in place, but these were not always operated effectively. This was because these systems had failed to pick up and/or take appropriate action to address a number of issues”
moderateRecord keeping: “while staff files contained at least one satisfactory character and/or employment reference for everyone the provider employed, most did not include a second reference.”
moderateStaff competency: “this induction was not mapped to the Care Certificate and therefore did not prepare staff for their role and responsibilities.”
minorInfection control: “the provider did not have an infection prevention and control policy in place”
Strengths
· Continuity of care from a small group of dedicated, punctual staff familiar with people's needs
· Staff treated people with kindness, dignity and respect; relatives described care as 'exemplary'
· Person-centred care plans tailored to individual needs, preferences and routines
· People's cultural, spiritual and equality needs respected and considered in staff matching
· Safeguarding systems in place; staff knew how to recognise and report abuse
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Preventing and controlling infectionGood
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
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
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
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: Planning and promoting person-centred, high-quality care and support; and how the provider understands and acts on duty of candour responsibilityGood
well-led: Engaging and involving people using the service, the public and staffGood