Right at Home

Updated 21 April 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice 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 25/02/2020 and ended on 02/03/2020. We visited the office location on 25/02/2020.

What we did before the inspection

We reviewed information we had received about the service since it registered with the CQC. We sought feedback from the local authority and professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We contacted Healthwatch for information they held about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and six relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, the care manager, the managing director, national compliance officer and care workers. We reviewed a range of records which included three people's care records and three staff files. We looked at a variety of records relating to the management of the service, including policies and procedures. We also visited a person's home whilst staff were present to observe staff interactions, review records kept within the home and seek feedback.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional case studies, and information provided by the registered manager. We contacted and received feedback from three professionals.

Updated 21 April 2020

About the service

Right at Home (Cheshire East) is a domiciliary care agency providing personal care to people in their own homes. 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. At the time of inspection, eight people were receiving regulated activity.

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

People felt safe and staff understood their responsibilities to safeguard people. Risks were fully assessed, and appropriate resources, equipment and external service input identified. People were supported by a consistent staff team. Systems were in place to learn lessons when things went wrong, such as accidents and incidents, and action was taken to prevent future risk. We have made a recommendation to ensure recruitment processes are followed and are suitably robust.

People’s needs were fully assessed, and appropriate steps taken to ensure equipment and resources were in place to meet people’s needs. Staff were well trained and supported to do their role. Staff worked closely with other health care services to deliver appropriate care and support. People were supported to eat and drink and a balanced diet was encouraged. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff consistently sought consent from people and involved them in decision making.

Staff were kind and caring and knew people well. Staff knew how to involve people in decision making and fully respected people’s privacy and dignity. People’s diverse needs were considered, and care plans tailored to meet individual needs. Staff knew how to support people and encouraged them to remain as independent as possible.

Care plans were person centred and reflected people’s needs and preferences. These were reviewed regularly, and people and their families were fully involved in this process. People felt able to raise concerns, and these were investigated and responded to. The registered manager worked closely with local services to provide end of life care for people, and staff knew how to provide compassionate care to people and their families at that time.

The management team were committed to delivering good care. Feedback was consistently sought from people who used the service and learning was shared across the staff team. Good practice guidance was considered and work ongoing to embed this practice. People spoke positively about the registered manager and told us they were approachable and responsive to concerns. The registered manager was organised and understood their regulatory duties.

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

Rating at last inspection

This service was registered with us on 03/07/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service registered with CQC.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.