Right at Home (Maidenhead and Slough District) was rated Outstanding overall at its September 2021 inspection, retaining the rating from its previous 2019 inspection, with Responsive and Well-led rated Outstanding and Safe, Effective and Caring rated Good. The service demonstrated exceptional person-centred care, outstanding leadership, deep community involvement and a strong learning culture with no failure themes identified.
Strengths
· Exceptionally person-centred care with detailed, holistic care plans matched to individual life histories, preferences and goals
· Outstanding responsiveness including proactive social inclusion, community integration and prevention of social isolation
· Strong continuity of care worker allocation with staff matched to people based on shared interests, culture and personal traits
· Excellent staff training including specialist dementia champions and formal qualifications supported by the management team
· Robust complaints and incident learning system with lessons embedded into practice and staff communications
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesOutstanding
responsive: Supporting people to develop and maintain relationships to avoid social isolationOutstanding
responsive: End of life care and supportOutstanding
responsive: Improving care quality in response to complaints or concernsOutstanding
responsive: Meeting people's communication needsOutstanding
well-led: Continuous learning and improving care; working in partnership with othersOutstanding
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsOutstanding
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringOutstanding
well-led: Engaging and involving people using the service, the public and staffOutstanding
well-led: How the provider understands and acts on the duty of candourOutstanding
Right at Home (Maidenhead and Slough District) was rated Good overall at its September 2016 inspection, with strengths in safe care delivery, person-centred practice, complaints handling and well-led management. The service requires improvement in Effective due to overdue staff training (including safeguarding and medicines), insufficient supervision and appraisals, and non-compliant consent practices under the Mental Capacity Act 2005.
Concerns (5)
moderateStaff training: “safeguarding training and practical medicines training were out of date. We also found that an unsatisfactory number of staff had completed performance appraisals”
moderateSupervision / appraisal: “the nominated individual told us that the service planned quarterly supervisions for staff. However, we found that there were not an appropriate amount of supervision sessions for all staff”
moderateConsent / capacity: “the service relied on relatives or 'next of kin' for agreement and signatures on consent forms. The service did not obtain proof that the relevant person could consent on behalf of the person”
minorMissed or late visits: “from 2 July 2016 to 4 September 2016, there were 7,184 calls. Of those calls, 213 or 3% were late by more than 15 minutes and 0.9% were late by more than 30 minutes”
minorGovernance: “a recent notification of a safety event was not sent to us by the service 'without delay'. This meant that we did not receive information in a timely way, in line with the relevant regulation”
Strengths
· People felt safe and staff were professional, caring and knowledgeable about people's needs
· Robust recruitment and selection procedures including DBS checks with no missing documents
· Medicines were safely managed with written policy, staff training including practical demonstrations, and MAR monitoring
· Care plans were person-centred, regularly reviewed, and reflected individuals' backgrounds, preferences and outcomes
· Complaints were handled appropriately with timely acknowledgement, investigation and written responses
Quality-Statement breakdown (18)
safe: Protection from abuse and neglectGood
safe: Risk assessment and managementGood
safe: Staffing levels and deploymentGood
safe: Medicines managementGood
safe: Recruitment and selectionGood
effective: Staff training, supervision and performance appraisalRequires improvement
Right at Home (Maidenhead and Slough District) achieved an Outstanding overall rating at its April 2019 inspection, with exceptional responsiveness and leadership evidenced by highly personalised care, innovative community initiatives, and overwhelmingly positive feedback from people, relatives, and professionals. No failure themes were identified; the service demonstrated strong compliance across all five key questions.
Strengths
· Exceptional person-centred care with bespoke support plans enabling people to remain in their own homes and regain independence
· Outstanding responsiveness including staff matching by personality, interests, language and cultural background
· Strong leadership from director and registered manager with clear values and ethos placing people at the heart of the service
· Innovative community engagement including a wheelchair vehicle, Clients' Forum, and diverse social activities to reduce isolation
· Robust quality assurance systems including real-time electronic monitoring of visits and medicines, quarterly self-audits and external surveys
Quality-Statement breakdown (20)
safe: Systems and processes to protect people from abuse and avoidable harmGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safely; preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
effective: Access to healthcare servicesGood
caring: Kindness and compassionGood
caring: Involvement in care planningGood
caring: Privacy and dignityGood
responsive: Person-centred care planningGood
responsive: Staff knowledge of peopleGood
responsive: Complaints handlingGood
well-led: Clear objectives and valuesGood
well-led: Approachable and visible managementGood
well-led: Quality assurance systemsGood
Good
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to live healthier lives and access healthcare servicesGood
caring: Ensuring people are well treated and supported with compassion and kindnessGood
caring: Supporting people to express their views and be involved in decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlOutstanding
responsive: End of life care and supportGood
responsive: Improving care quality in response to complaints or concernsOutstanding
well-led: Managers and staff being clear about their roles; understanding quality performance, risks and regulatory requirementsOutstanding
well-led: Engaging and involving people using the service, the public and staffOutstanding
well-led: Planning and promoting person-centred, high-quality care and duty of candourOutstanding
well-led: Working in partnership with othersOutstanding