Ryedale Homecare

Updated 29 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

One inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service a short notice period of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 16 September 2022 and ended on 27 September 2022. We visited the location’s office on 16 September 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to the registered manager and senior carer as part of the inspection. We reviewed a range of records. This included two peoples care records and multiple medication records. We looked at three staff files in relation to recruitment and supervisions and a variety of records relating to the management of the service.

After the inspection

We spoke to four relatives, three people who used the service and six staff members. We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and quality assurance records.

Updated 29 October 2022

About the service

Ryedale Homecare is a domiciliary care service providing personal care to young adults and older people who may be living with dementia, physical disabilities, a learning disability or autism spectrum disorder. At the time of our inspection there were 19 people using the service.

Not everyone who used the service received personal care. 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 provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support:

People were not always supported in a way which promoted safety. Risk assessments were not in place to reflect people's current needs. We could not be assured these risks were known to staff and mitigations were in place to help minimise the risk of harm. People told us they received their medication when required, however, records did not reflect this. People were not always supported to have maximum choice and control of their lives and records did not reflect staff were working in their best interests; the policies and systems in the service were in line with best practice guidance but their practice did not support this. We have made a recommended for the service to review their understanding of the Mental Capacity Act 2005.

Safety and quality within the service had not always been assessed. Audits did not highlight the concerns raised at the inspection and there was no evidence that practice had been improved when something went wrong.

People told us they were well supported and praised the staff team. One person told us, “We’ve never been unhappy and there have been no concerns at all.” One relative, when discussing the support provided by the service, told us, “The staff have been tremendous".

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity and understood and responded to people's individual needs. However, more detail was needed in the care plans to ensure people’s needs and preferences were fully understood and recorded. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

We received positive feedback about the care provided. One person told us, “My overall impression is that they are very good and always treat me with the utmost respect. We’re all like friends now and its really lovely. The way that they care for me is just wonderful."

Right Culture:

The management team and staff promoted a caring culture, were providing person centred care was the focus of the service. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. People were asked to provide feedback on the care provided and they had confidence in the registered manager to deal with concerns appropriately. Staff felt supported in their roles and were provided with the opportunity to discuss any issues which they may have in an open and inclusive way.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 February 2021) and there was a breach of regulation. At this inspection we found the provider remained in breach of regulations. This service has been rated as requires improvement for the past two inspections.

Why we inspected

We carried out an announced focused inspection of this service on 8 December 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains as requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ryedale Homecare on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safety and governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.