Respect Care Services Limited achieved a Good rating across all five key questions at its December 2017 inspection, having successfully remediated five regulatory breaches identified in 2016 relating to risk assessments, consent, person-centred care, notifications and governance. The service demonstrated strong personalised care, effective quality assurance systems, well-trained staff and responsive leadership.
Strengths
· Personalised, up-to-date risk assessments with clear guidance for staff on managing and minimising risk
· Medicines administration records accurately completed, regularly audited, and staff competency assessed via spot checks
· Staff received annual safeguarding refresher training and demonstrated understanding of abuse recognition and reporting
· Mental Capacity Act compliance improved since previous inspection; capacity assessments recorded and consent obtained
· Locality-based staffing reduced travel time between calls, minimising late or missed visits
Respect Care Services was rated Requires Improvement overall following an announced inspection in October 2016, with five regulatory breaches identified across safe care and treatment, consent, notifications, and governance. The service demonstrated caring practice and adequate staffing, but was undermined by inconsistent care records, failure to report safeguarding incidents to the CQC, absence of care record audits, and non-compliance with the Mental Capacity Act 2005.
Concerns (8)
criticalCare planning: “some people's care plans and risk assessments were inconsistent and sometimes lacked information.. For example, in one person's care record we found inconsistent records kept with regard to whether the person smoked.”
criticalRecord keeping: “incomplete or inconsistent record keeping that could have placed people at risk of avoidable harm.”
criticalConsent / capacity: “care records that were not signed by the person using the service...no indication within the records about whether the person had the capacity to make this decision.”
criticalGovernance: “did not see evidence of audits or any other monitoring of care records...provider was not assessing, monitoring or mitigating the risks we found to service users.”
criticalSafeguarding: “We identified two safeguarding incidents that had not been reported to CQC as required so that these could be assessed and action taken where appropriate.”
moderateSupervision / appraisal: “appraisals were not conducted regularly...some staff had not had an appraisal for over two years.”
moderatePerson-centred care: “care records contained very limited details about people's needs or preferences...very limited or no information about people's life history or preferences in relation to how they wanted their care to be delivered.”
moderateMedication management: “any discrepancies in recording or any errors in the administration of medicines may not have been identified or addressed for a significant period of time after the incident occurred.”
Strengths
· Staff demonstrated a good understanding of safeguarding procedures and how to recognise and report abuse.
· Recruitment procedures ensured only suitable staff worked at the service, with thorough documentation including DBS checks and references.
· People and relatives gave consistently positive feedback about care workers, noting kindness, compassion, and respect for privacy and dignity.
· Care workers had good knowledge of people's cultural backgrounds, religions, and personal histories.
· Staffing levels were sufficient and people reported being seen by consistent, familiar care workers.