Ruby Grange Homecare Limited

The service is a domiciliary care agency and is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom could be living with dementia and younger disabled adults.

At the time of our inspection, the provider was offering a service to 14 people.

This was the service's first inspection following their registration with the Care Quality Commission on the 5 December 2016. 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.

Staff and the management team were described as very caring and kind. Staff demonstrated an empathetic approach to working with people and supported people's emotional wellbeing. People were supported to access appropriate health care and staff recorded what people ate and drank to monitor their nutrition and hydration. Staff demonstrated they understood they should report any concerns about people's health to the management team so they could take appropriate action.

The registered manager assessed the staffing requirements within the service to ensure they had enough staff before accepting new referrals. The management team supported people with their care when there were staff absences to ensure a consistent service.

The provider followed safe recruitment processes to ensure staff were suitable to work in a caring capacity. Staff were given a thorough induction and training to equip them to undertake their work.

The management team had undertaken risk assessments to identify the risks associated with the delivery of care in a person's home, but sometimes these lacked a person centred approach and did not state the level of risk to the person. However, care plans were thorough and contained good guidance for staff to mitigate risk. We brought this to the registered manager's attention and they addressed this following the inspection.

Staff were not administering medicines at the time of our inspection however staff had received training and had clear guidance about who administered medicines and the type of support people needed with their medicines.

The management team understood their responsibility under the Mental Capacity Act 2005 and ensured people's rights were being upheld. Staff demonstrated they asked people's consent before proving care and support.

People had person centred plans that gave guidance to staff about how they wanted their care delivered. Care plans were signed by people to show they agreed with the content and these were updated and reviewed on a regular basis to capture changing circumstances.

People and relatives said they knew how to complain and they found that their concerns were addressed in a timely manner by the registered manager.

The management team shared the company's vision and ethos with the staff in their induction and training. They acted as role models to show how they wanted care to be delivered.

The management team had a good oversight of the way the service was provided because they had quality assurance systems including audits and checks to ensure the quality of the care provided.

The management team had joined a national organisation and were accessing training to ensure they kept abreast of good practice.

The five questions we ask about services and what we found