Right at Home South Cheshire

This was the first inspection of Right at Home South Cheshire since it was registered in December 2016.

This service is a domiciliary care service. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.

Right at Home South Cheshire (Right at Home) operates as a franchise of Right at Home UK. It provides care and support to people in their own homes including; companionship, home help and personal care. This report focuses on the experiences of people who received personal care as part of their support package. Most of the people who use the service are older people, some of whom are living with dementia. Right at Home provided services to 37 people at the time of our inspection. 18 people received the regulated activity of personal care.

The service had two registered managers in place at the time of the inspection.

People were supported by staff who were exceptionally kind, caring and compassionate. Each of the people we spoke with was very positive about their relationship with their care givers and the manner in which they were treated.

The staff that we spoke with clearly knew the people they cared for well and provided care in a genuinely person-centred way. Each of the care records that we saw contained detailed information about people's care needs, their likes, dislikes and personal histories.

We saw clear evidence that staff had worked in their own time for the benefit of people using the service. People using the service and their relatives were given additional support during difficult periods.

We saw from records that people had shown significant improvement in their physical and mental health and wellbeing since receiving support from Right at Home. People told us that care givers always treated them in a respectful way and provided care in a way that maintained their dignity.

People, relatives and staff told us the service was exceptionally well-managed and communicated effectively with them. They said the service they received from the office staff was friendly, professional and efficient.

The management team carried out regular checks, including spot checks to ensure that staff continued to demonstrate the service's values in their day to day work. The registered care manager and deputy care manager regularly worked with care givers to provide additional support as required.

Staff were provided with the support they needed to deliver outstanding care. This included; regular supervision and appraisal, team meetings, effective communication, additional training and informal support. Staff were also actively encouraged to speak-out and make suggestions to improve safety and quality.

It was clear that the management team had worked effectively with people using the service, community professionals and staff to deliver high-quality, person-centred care. Care records and comments provided evidence that this had been the case when the service was first registered. It was equally clear that service quality had continuously evolved and improved to meet the needs of individuals and the wider community.

The management team organised events that were open to people receiving care but also benefited people in the local community who did not use the service. For example, a chair-based exercise group had been recently established in the service's offices. Right at Home made extensive use of its shop-front location to promote other activities and events in the local area. For example, Dementia Friends events had been regularly delivered with the support of the Alzheimer's Society.

Right at Home had established effective working relationships with other professionals involved in people's care, including GPs, district nurses and occupational therapists. The professionals we contacted told us the service was well managed and maintained high standards of care and professionalism.

Right at Home demonstrated a clear commitment to learn from incidents and actively encouraged people receiving care and staff to make suggestions for improvements in safety and quality. The responses to the 2018 surveys provided positive feedback about the service, with many people highlighting the caring and responsive approach of staff. 100% of the people who responded said that the service was making a positive difference to their life. 100% of the respondents said they were likely or highly likely to recommend Right at Home.

People told us they felt safe receiving care from Right at Home. Staff were knowledgeable about the types of abuse and neglect people may experience and in recognising the signs of abuse. Staff knew how to report their concerns and told us that they would not hesitate to whistleblow (report concerns to an external body) if necessary.

Staff were safely recruited following the completion of appropriate checks. Each staff file that we saw contained at least two satisfactory references, photographic identification and evidence of a recent Disclosure and Barring Service (DBS) check. DBS checks are used to help employers establish if applicants are suited to working with vulnerable people.

Where people's care involved support with medicines, this was managed safely. The medicines' policy was extensive and provided clear guidance for staff regarding safe practice and legislation. Staff responsible for administering medicines had been trained in this area and their competency had been assessed.

People received their care from staff who were well trained and supported. People and their relatives told us the staff were of a consistently high standard. Staff were given the induction, training and support they needed to do their jobs to a high standard. New staff were required to complete the Care Certificate.

People who received support with meals told us they enjoyed the food their care givers prepared and that their care givers knew their dietary needs and preferences. Staff commented that the minimum call time of an hour gave them time to prepare meals from fresh ingredients rather than just re-heating pre-prepared meals.

Each person had an individual care plan developed from their initial assessment. This was done with the involvement of the person and/or their representative. Care plans provided detailed guidance for staff about people's needs and the way they preferred things to be done. Care plans and risk assessments were subject to regular review to ensure that they reflected current needs.

Right at Home had a complaints procedure which was provided to people and their relatives when they started to use the service. The majority of people told us they had not needed to complain as the provider contacted them regularly to hear their views and ask for feedback about the service. Where people had felt the need to complain or raise concerns, the service had responded promptly in accordance with policy to resolve the matter and produce a written response.

The five questions we ask about services and what we found