About the service:

Reedsfield Care Limited is a domiciliary care service that was providing personal and nursing care to 26 people within their own homes. The service supported older people, people with physical disabilities, learning disabilities and mental health conditions.

People’s experience of using this service:

People told us they felt safe but we found continued shortfalls in relation to medicines, risks and care planning. Records relating to medicines were not accurate and where risks were identified the plans to keep people safe were not robust. Care plans were inconsistent and we found instances where important information about people’s needs and preferences was lacking. We also found a lack of information about people’s food preferences.

The provider had not always completed assessments in a timely manner which meant important information about needs and risks had not been gathered and planned for. People told us they were not always sure what time to expect staff and we found instances where the provider was not following their policy regarding call times. People had consented to their care but we found one instance where records relating to this needed improving. Records were not always up to date or complete. The provider's auditing and governance processes were not proactively identifying and addressing the issues that we found. The provider had not always notified CQC of incidents they were required by law to.

People told us that the staff who supported them were caring and we heard examples of people being supported to develop skills and independence. People told us that staff were respectful when providing care in their homes and were competent in their roles. Staff had received training and regular checks and supervision to assess their practice. There were regular staff meetings and staff told us important information was passed to them each day through handovers. Records showed regular work with other organisations and referrals to healthcare professionals when required.

Rating at last inspection: Requires Improvement (Published 18 May 2018).

Why we inspected: This was a planned comprehensive inspection based on the previous rating.

Enforcement: Action we told provider to take (refer to end of full report)

Follow up: We will request an action plan from the provider and continue to monitor the service. We will return to the service to inspect it again in line with our policy.

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

This inspection took place on 21 and 22 March 2018 and was announced. This was the first inspection for this service since registering with CQC in March 2017.

Reedsfield Care Ltd is a domiciliary care agency. They provide hourly support to people within their own homes. At the time of our inspection there were 15 people receiving personal care. The service provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people with physical disabilities and people with long term medical conditions.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was not always robust governance at the service. We identified issues that the provider had identified through audits but these had not been addressed. Records relating to people’s medicines contained gaps and despite these having been identified in audits, they had not been addressed by the time of our visit. We also found that some information in people’s care records lacked detail and that negative feedback about time keeping identified in surveys had not been addressed.

We also found some records relating to individual risks lacked guidance for staff. Shortfalls in medicines records meant that medicines management was not always safe. You can see what action we told the provider to take at the back of the full version of the report.

People were supported by staff that had the training to carry out their roles. Staff told us that they felt supported by management and had regular supervision meetings. Staff were trained in best practice with regards to infection control and were knowledgeable in this area. Staff met regularly to discuss care delivery and the registered manager had an open door policy. We did receive some negative feedback about staff punctuality. We made a recommendation about staff deployment.

Risks to people were assessed and managed safely. Where people had suffered incidents, such as falls, staff took appropriate action and the provider kept a record of these and analysed them. Staff understood their roles in safeguarding people from abuse and were knowledgeable about people’s needs. People were provided care in a way that promoted their independence and they received person-centred care. However, we did find instances where records lacked detail. We made a recommendation about care planning.

People were supported by kind and caring staff that they got along well with. Staff were respectful when entering people’s homes and provided care in a way that preserved people’s dignity and was respectful of their privacy. People were given choices by staff and involved in their care. Staff sought consent from people and this was documented. We did find one instance where documentation was not up to date for a person who could not consent. We made a recommendation about consent records.

People received a thorough assessment before they received a service and people’s care was regularly reviewed. Staff met people’s nutritional needs and supported people to access healthcare professionals where appropriate. People were regularly asked for feedback on the care that they received there was a clear complaints policy in place. Where people had raised a complaint, the provider had investigated these appropriately and identified actions to address concerns.

The provider carried out checks on all new staff to ensure they were suitable for their roles. There was a vision for the service and the provider had developed links with the local community. There was a plan to ensure that people’s care could continue in the event of an emergency.